TUB&RCULOS 



OICSK 



CONSUMPTION 




f 



JK 




BY 



H. H. SPIERS, M. O. 

R. NA. OHIO, 








GipgtaH?.J.3l2^: 



COPYRIGHT DEPOSIT; 



TUBERCULOSIS 



OR 



CONSUMPTION. 



— BY — 

J 
H. H. SPIERS, M. D., 

I) 

RAVENNA, OHIO. 






THE LIBRA 
CONGRL 
One Copy Received 

FEB. 9 

Cop^wwht pntpv 

CLASS «-XXo. Nn. 
^ 7. I L> %^\ 
COPY 8. , 



COPYRIGHT I902, 
BY 
HENRY H. SPIERS, M. D. 
RAVENNA, OHIO. 






4 



To 
A Weak, Common 

and 

Suffering Humanity 

These Articles 

are 

Respectfully Dedicated 



Preface to First Edition. 



In offering these papers for 2 second reading, it is the 
hope they will diffuse a brighter light by a collective ren- 
dering. Short articles, given from time to time, on various 
topics, and in many journals, seldom come under the eye 
of one individual. Hence the necessity of unity in presen- 
tation. The intractable nature of tuberculosis is our only 
apology. 

Respectfully, 

H. H. SPIERS, M. D. 
Ravenna, Ohio. 



Preface to Third Edition 



Fourteen years ago the law of tuberculosis was given 
the Portage Count}* Medical Society, at Ravenna, Ohio. In 
December, 1890, it was presented to the profession at large 
through the Cleveland Medical Gazette. During this pe- 
riod of twelve or fourteen years, the writer has constantly 
been before the medical public, upwards of one hundred ar- 
ticles have issued from his pen, in current medical literature. 
To-day, as never before, the causation and prevention of 
tuberculosis is clearly recognized. 

In this third edition of tuberculosis the writer endeav- 
ors to present more clearly the manifest workings of law. 
In this attempt the generous patronage of an unbiased pro- 
fession is asked. 

H. H. SPIERS, M. D. 
Ravenna, Ohio, Jan. 31st, 1902. 



PRELIMINARY STATEMENT. 

As my view of the origin of tuberculosis is at variance 
with established teaching, perhaps a. simple statement of be- 
lief is necessary. 

i. Tuberculosis is a constitutional disease, dependent 
largely on the evils of civilization, and governed by the fol- 
lowing law : The death rate from tuberculosis is in direct 
ratio to suspension of atmospheric influence. 

2. The suspension or abeyance of atmospheric influ- 
ence may take place from within or from without. From 
without through impure or impoverished atmosphere ; from 
within through defective lung tissue, original or acquired. 

3. Abej-ance of atmospheric influence, in whatever 
way induced, causes a depraved tissue or dyscrasia, through 
which the tubercle bacilli enter and grow. 

4. The growth of tubercle bacilli, being dependent on 
the precedent state or condition of the individual, is never 
■per sc the primary cause of tuberculosis. 

5. Tuberculosis may exist, though infrequent, in the 
absence of tubercle bacilli, but can never exist without the 
precedent state or condition. 

6. The plant growth, being a secondary condition or 
modifying influence in this most fatal disease, treatment di- 
rected against this growth must ever remain barren of per- 
manent curative results and dangerous to the patient. 

7. The precedent or primary condition being subject 
to law, and under control, tuberculosis is under control. 



II 



MEDICAL THEORIES. 



When a small boy there came to my hands a pamphlet, 
which stated' the earth is flat, like a table, and rests on 
four huge elephants ; each elephant stands oil four tortoise. 

Child-like I ask mother, what do the tortoise stand on? 1 

To me the theory was highly significant, but to be 
complete it required a little earth filling. 

Many theories of the past have been shown to rest on 
equally unstable bases. Many theories of the present, I 
apprehend, will be shown equally illusory. 

Many questions will be asked in the same child-like 
simplicity, and many learned disqusitions will be given to 
prove that which never did exist. Such is life, and such is 
the history of all human progress, with its periods of per- 
tinacity and vacillation alternately shown. Would you then 
discard all theory ^ By no means. Theory answers a great 
purpose in the world's advancement on scientific lines. 

Our theories are in one sense our ideals. We search 
for and endeavor to establish that which we really believe 
to be true. Thus far, theory is laudator}'. But it is evi- 
dent a theory must be based on some thing more than pure 
imagination. 

is the earth flat like a table, etc.? Would it not be better 
to take established truth as a ground-work, and build on 
this? 

But where can established truth be found? 

In medicine, in theology and in law we are constantly 
in search of it. 

Oft-times truth lies close beside us and zve see J 
not. 

To-day the great medical telescope is located in Ger- 
many. Multitudes of people flock to hear its revelations. 



12 

Nothing worthy of credence, observation or regard is seen, 
except through this instrument. 

To-day it is a bacillus— To-morrow a coccus. 
Each day is prolific in new schemes of detecting, cap- 
turing and destroying microbes. A very laudable under- 
taking to say the least. 

One microbe is accused, tried and condemned and the 
sentence is pronounced. Another passes through the same 
ordeal and comes out innocent. 

In the fatherland, a microbic court-of-law is in session 
at all seasons of the year. The strangely curious thing is : 
That whether innocent or guilty it matters not. No mi- 
crobes have received capital -punishment in situ. 

In other words, no remedies have been found that will 
eliminate or destroy the microbe without causing the death 
of the patient. Let us look further. 

The savant Koch has demonstrated that in tuberculosis 
there is generally found a microbe at the seat of lesion. 
This is called the bacillus tuberculosis, for it is found in no 
other disease. That the microbe is present is universally ac- 
knowledged. They have been seen in colonies, in diseased 
tissue, by innumerable observers. Seeing is believing. 
Thanks to our distinguished contemporary. That this ba- 
cillus is the cause of the disease named has been received 
without serious question. 

The only serious question has been how to rid the sys- 
tem of the microbe. 

The result of treatment has been already shown. 

That the disease may be modified by the presence of the 
bacillus, I think there can ])e no serious doubt . 

That the microbe has any casual action in producing 
the disease is, in my judgment, pure speculation. 

Astronomers tell us that presumably the planet Mars is 
inhabited. 

If inhabited, who can say its people are not well up in 
the arts and sciences —possibly have telescopes. 

Imagine a resident of Mars engaged in the stud}- of as- 
tronomy. Through his telescope he views the surface of 



—13— 

the earth and sees a flock of crows hovering near the car- 
cass of a sheep. What are these crows doing ? Day by day 
he watches them closely. They are eating the sheep. At 
once he concludes that the sheep are being killed by the 
crows. A book is written. This is standard authority in 
Mars. 

But one observer sees a dead sheep on which there are no 
crows. Again he looks and descries another. He publishes 
his observations, and asserts that sheep die from other causes 
than crows. Is not the conclusion a valid one? 

Again and again observers have found bacilli in the 
sputum and lung tissue of phthisis pulmonalis. Observations 
to this effect have been published from time to time. The 
microbe is charged with causing the disease. This is stand- 
ard authority. But one observer finds a case of phthisis pul- 
monalis in which no bacilli can be found in the sputum or 
lung tissue. He publishes the results of his observations 
and I assert that people die of phthisis pulmonalis, in which 
the bacilli do not enter as a factor. 

Is not the conclusion a valid one ? 

A new observatory is now erected on the planet Mars. 
Its telescope is of the finest make and highest power. The 
observer brings his instrument to bear on the planet earth, 
and sees not only dead sheep and live crows in abundance, 
but also multitudes of little birds which he calls sparrows. 
He watches these little birds closely. They are engaged in 
a contest with the crows. " They fight fiercely. At length 
the sparrows are victorious and the crows are driven from 
the field. 

The astronomer concludes his writings by saying that 
in order to prevent the death of sheep on the earth it is only 
necessary to increase the number of sparrows. A few tim- 
idly object to this teaching, but it is standard authority in 
Mars. Sparrows are now plenti ful, but sheep still die. 
Something wrong. 

A new scheme is now devised to clear the earth of its 
dread visitant, phthisis pulmonalis. It has the sanction of 
high medical authority. Phthisis pulmonalis is caused by 



— 14— 

tubercle bacilli. Two methods are open to rid the system of 
these microbes; the direct and the indirect, analogous to our 
dealings with the Indians in the past. Direct, to kill him: 
indirect, to take him from his feeding ground. In either 
event the microbe or Indian must die. A few timidly ob- 
ject, but this is standard authority. Tuberculin is plentiful, 
but mankind still die of phthisis. Something wrong. 

Science, though slow, makes progress even in Mars. 
A pains-taking observer has been watching a sheep for 
many months. He has seen the animal die. Crows could 
not have killed him, for none are in that neighborhood. A 
brother astronomer examines the sheep and says he finds 
foot-prints in the earth near by — probably crow tracks. 
The crows killed the sheep, but were driven away by the 
sparrows, or fled from sonic other cause Science in Mars. 

Likewise in earth science is progressive. A pains- tak- 
ing observer has been watching a case of phthisis pulmon- 
alis for many months. No bacilli are found in the sputa, 
though many examinations for the same have been made. 
The patient dies. No bacilli are found in the lung tissue. 
A brother scientist examines the body and finds tubercular 
nodules in the lungs. The bacilli caused the patient's 
death, but were either driven away or fled Jrom some other 
cause Science in the earth. 

The second observer in Mars reasons thus: Sheep die 
from various causes. Crows alone do not kill sheep. 
Crows simply eat the flesh of sheep after the}" are dead. // 
is the condition of the shce-p that allows the crow to begin 
cat i u o\ 

The second observer in the earth reasons thus: Man- 
kind die from various causes. Tubercle bacilli alone do 4 
Bot kill mankind. Tubercle bacilli simply enter the tissue- 
as a feeding ground. // is the condition of the system that 
allows the bacilli to enter. 



15- 



LAW IN TUBERCULOSIS. 

In mathematics, whenever a regularity can be traced, 
the general proposition expressing that regularity is called 
a lav\ . For many years I have been led to believe that 
tuberculosis is obeying certain fixed law, as the planets obey 
law in revolving around a central sun. To the general ob- 
server this statement may seem chimerical. 

Zone. Ventilation. Death Rate. Ratio. 

Frigid o Perfect o . . . . Zero i 

Torrid 5 . . . Less perfect 5 . . . . Small 1 

Temperate 10 . . Least perfect 10 ... . Great 1 

The ratio between ventilation and death rate is always 
constant. 

Tuberculosis obeying law ? Apparently no order in 
appearance or disappearance. No regularity in mode or 
extent of visitation. Coming and going like the wind, or a 
bird of the air — all is chaos, discord and confusion. So 
thought the ancients of the worlds about us. But soon law 
is discovered; order is evolved; a system is formed and it is 
found that not only do the planets move, but in regular 
orbits and with matchless precision. Stand by the seaside 
and watch the incoming and outgoing tide. Note with ac- 
curacy the flood and ebb of waters. Without previous 
knowledge }~ou could assuredly say these waters move in 
obedience to law. A law now fairly well understood — the 
law of gravitation. 

Stand by the bedside and observe the death rate from 
tuberculosis. Note the accuracy the figures tally year by 
year: Frigid zone, o; Torrid zone, small; Temperate zo::e. 
great Without previous knowledge you could assuredly 
say these factors are essentials to the formation of lav.-. 
On these essentials is based the law of tuberculosis. Extend 
your observations to the coast line of a continent. Mark 
the varied difference in tidal wave in the various latitudes. 
Truly, you could say this law is not equally potent at all 
places — but observe it is, nevertheless, the same law, an 1 
the difference in height of tidal wave is due to the coast line 



-i6— 

of the continent. Extend your research to prevalence of 
tuberculosis in the cities of the world. Mark the varied 
difference in places of the same latitude. Truly, you could 
say here is absence of law. But observe the same law pre 
vails, and the difference of prevalence is due to abeyance 
of atmospheric influence. 

I herewith give, from standard authors, the maximum 

of tide for the places named; 

Bay of Fundy ,75 ft. 

Boston 10 ft. 

Straits of Magellan 50 ft. 

Florida Reefs 2 ft. 

Head of Persian Gulf 36 ft, 

Mid-ocean 2 to 3 ft. 

I herewith append, from W. Halle, a partial tabic 

showing the prevalence of tuberculosis per ten thousand, 

1889 to 1890, for cities named. 

Brunn 76.7 

Baltimore 24.9 

St. Petersburg 48.8 

London .........18.4 

Vienna : 54.4 

Rome. 22.5 

As the difference in height of tide along the sea coast 
does not invalidate the law of gravitation, neither does the 
difference in per cent of tuberculosis in the various cities 
invalidate the law of tuberculosis. 

In truth, the law in both cases is verified by the appar- 
ent contradiction. 

In dealing with the problem of the tides we find it 
complex and difficult. Equally complex and difficult is the 
problem of tuberculosis. If the tide and tuberculosis be 
alike based on law, they should alike be susceptible of dem- 
onstration, and barring preconceived opinions, should alike 
be worth}- of credence. 

As already stated., the death rate is modified by abey- 
ance of atmospheric influence. The stabled cow, the penned 
sheep, the tame rabbit, the caged monkey, lion, tiger or 
elephant almost invariably die of tuberculosis. Seldom*, or 
never, do these animals die of this disease if living in the- 



open air. The disease prevails much more among those 
whose vocations are sedentary than among those whose 
occupations are out of doors. The mortality in prisons has 
been shown to be four times as great as outside. The 
death rate from phthisis is estimated at fifteen per cent of 
the total mortality, while in prisons it is from forty to fifty 
per cent. 

Primary tubercular lesions are, in a majority of cases, 
connected with the respiratory organs. 

"There is nothing essentially destructive or necessarily 
fatal in tuberculosis. That in all stages it may be checked 
and enable the person affected to live man)- years, and die 
subsequently of old age or other disorders." 

The Rev, josiah Strong, author of "Our Country," 
said in ni)' presence, a number of years ago, words like 
these: "When a young man I was declared consumptive. 
Sentence of death was pronounced by able physicians, east 
and west. I took no medicine; ate plain food and lived 
wholly in the open air. Today I am the picture of health." 

Dr. Joseph Parish, of Philadelphia, gives a similar 
experience. 

Many, no doubt, can recall cases that have a like bear- 
ing. It is, therefore, seen a constant ratio exists between 
ventilation and death rate. As the ventilation becomes poor, 
the death rate increases and vice versa. The law then, as 
laid down in October, 1890, is simplified thus: The ratio 
between ventilation and death rate is always constant. In 
order to present this more clearly to the intellect, through 
.the eye, I have arranged the following table: 

Zone Ventilation Death Rate Ratio 

Frigid ......... o .• . Perfect o Zero . . . . 1 

Torrid 5 Less perfect 5 Small . . . . 1 

Temperate .... 10 ... „ Least perfect 10 ... . Great . . . . 1 

If, then, a regularity be traced, what shall we say of 
law:* According to the definition, law must exist. 

But it has been said that confinement, with insufficient 
ventilation means the presence of the bacillus. Observe 
this. Exposure to atmosphere breathed by consumptives 
is not attended with danger so long as good ventilation is 



maintained. Observe this: 111 ventilation, whether in the 
private room or crowded tenement, invariably increases the 
death rate. Good ventilation, then, insures immunity. Ill 
ventilation insures death. Can this much be said of the 
absence or presence of the bacillus? Is tuberculosis caused 
by the bacillus? Before the world today it stands not proven . 

Look upon that field, with its depression in the center. 
The rains of heaven fall upon that field. The depression is 
filled with water and it becomes a shallow lake. Rushes, 
reeds and grasses, peculiar to low places, begin to grow in 
that lake. Did the rushes, reeds and grasses cause the de- 
pression? Did the rushes, reeds and grasses cause the lake? 
Drain the lake, the rushes, reeds and grasses disappear. 
But, says the objector, can we not take these rushes, reeds 
and grasses and make them grow on the arid mountains? 
Yes, we can; but how great the labor and how small the 
result. 

Yes, we can; but nature does not work in that way. 

Look upon that man as he walks the streets. A bad 
family history, a prolonged illness — the depression in that 
field. Grinding poverty or pampered luxury has been his 
lot — the rains of heaven. Bacilli begin to grow in his 
lungs, are found in his sputum — the rushes, reeds and 
grasses. Did bacilli cause that man's history or illness? 
Did bacilli cause poverty or luxury? Take away the con- 
ditions, the bacilli disappear. But, says the objector, can 
we not inject bacilli, or a pure culture, into the healthy 
tissue and cause the disease? Yes, we can; but how great 
the labor and how small the result. 

Yes, we can; but nature does not work in that way. 

Tuberculosis caused by the bacillus? Tuberculosis is 
transgression of natural law. Violation of law brings its 
penalty; observation of law its reward. Standing near a 
spot sacred to every true American, I declare tuberculosis 
can be controlled. Not by the injection of chemicals — not 
by the injection of tuberculin, but by the observation of law. 



—i 9 — 



MARRIAGE, 



Should an attempt be made to analyze the cause of 
marriage one would inquire into the nature of the desire im- 
planted in the human breast. No attempt is made other 
than to express a judgment that it is largely social. In the 
beginning it was said: "It is not good that man should be 
alone." In this later da}' one portion of scripture seems to 
be tacitly acknowledged. 

Whatever the incentive that leads to marriage, whether 
love, impulse or ambition, in the eyes of the law united 
they are. The incentive -per se may be of little import, 
but the union is the weal or woe of two lives and succeeding 
generations. Generally speaking, the incentive is of great 
import. 

Two of opposite sex meet in a car or at a party and are- 
enraptured one with the other — a mutual liking. In what it 
consists even the participants can not explain, but it leads 
to marriage. 

One part}- sees another to whom he or she is attracted 
with an unwonted impulse, Every opportunity is sought 
for an introduction. The acquaintance leads to a wooing, 
which ends sometimes in an unrequited love, but more often 
in marriage. 

Another desires to rise in the social or financial scale — 
a very laudable ambition. Who does not. if honestly at- 
tained? The hand and heart are sought wholly for this 
purpose, under the guise of a fervent love — and ends in 
marriage. 

There are also those of sordid nature whole being is 
wrought up with having a good time. Matrimony has joys 
untasted. To these joys they are allured and seek kindred 
natures in marriage. 

Some seek wedlock as an oasis in the desert of life. 



— 20 — 

It is a constant theme of conversation; little else is thought 
of. Any one of the opposite sex is accepted readily. 
These subjects marry early in life. 

Some look on wedlock as a snare into which the unwary 
are entrapped. The subject is frequently referred to, but 
discernment is necessary in selection. These parties are 
hypercritical, and marry late in life, if at all. 

Again, we have the intellectual devotee, whose ques- 
tions, imaginary and otherwise, would deny the most ardent 
of lovers — who, in truth, settle marital questions as do the 
majority of people. 

Then there is the philosopher, who looks on wit, beau- 
ty and wealth as the mere accident or incident of fortune — 
the externals of life. Theoretically, these people have no 
choice except in health and a moral nature. Practically, 
the number who thus marry is very small. 

On examination, it is seen that in marriage, as in other 
things, all have a motive. Whatever the motive, the result 
attained is the home, the foundation and true secret of all 
organized society. On the purity of the motive hinges the 
secret of connubial happiness. Let those who contemplate 
wedlock and desire happiness study carefully this phase of 
the question. It will amply repay them. 

But marriage is something more than the union of two 
parties for life; it is the offspring — it is to give to that off- 
spring a vigorous life. 

Many a man or woman is deterred from marriage from 
fearing its burdens and responsibilities, largely how shall 
we feed, clothe and educate those granted us; but how few 
ask the greater question, how shall we best transmit health 
and long life to our children? A vigorous constitution — a 
fortune in itself — readily secures the great obje:t c - of life. 
Physical weakness, however great the fortune, is doomed to 
doubtful victory or defeat. 

How much wiser the parent who transmits health than 
wealth ! How much wiser the state that frames laws to 
secure healthy citizens than the one which legislates to 
amass individual wealth ! How little regarded by legislators ! 



—21 — 

Marriage is union — the joining of two segments, each 
incomplete in itself. Children are the fruit of this union. 

It is as consonant with reason to say that parents beget 
children after their kind as trees yield fruit after their kind. 
Observation shows it equally true. Still further, not only 
are the mental and physical excellencies or defects trans- 
mitted, but also the virtues or vices are transmitted in ex- 
cellence or deject. Let us endeavor to illustrate transmit- 
ted defect by a few familiar examples. 

A married couple start in life with good health as a 
fortune. By arduous toil a small tract of land is bought 
and a house erected. Another small tract is added. Still 
another, and so on, until five or six hundred acres are 
bought and paid for. Their life has been alone. Xo SaD- 
bath, no company, no holiday, no rest — continual toil early 
and late. I said alone — not so. Eight children have been 
added to that family. All are in poor health. The par- 
ents have been so engrossed in securing a competence as to 
forget a law of their being. 

Work — so commendable in all — carried to an extreme 
proves a vice. This vice is transmitted in physical weak- 
ness. The children must ever suffer the sin of their par- 
ents. We see this law illustrated in the wage-earner's fam- 
ily. Arduous toil, long hours, low wages, high rent, 
meager diet, etc., are some of the ways in which labor is 
degraded and physical vigor in parent and child emasculated. 
Legislation in behalf of those thus down-trodden is de- 
manded. It would be beneficial to the human race. 

Not alone in this regard is manual labor. Intellectual 
work is subject to the same law and grievance. Many a 
brain worker in the race of life has fallen by the wayside, 
or in an attempt to live or secure a competence has trans- 
mitted feebleness to his offspring. One instance of in- 
tellect and application is recalled, who buried twelve chil- 
dren under two years of age. 

This law is illustrated in the drink habit of today. 
How often we see the imbecile, the idiot and the deformed 
in the family of the confirmed drunkard ! Who can say 



— 22 

these children are not equally deformed in their moral na- 
ture? They certainly are. How readily we condone an 
obliquity in a child when we know the weakness of the par- 
ents. In these and kindred cases law can accomplish much 
but I am satisfied education can do more. Not until man- 
kind clearly apprehend the law of their being will they be 
enabled to rise above a common level, even with the aid of 
human statute. How inefficient the best of statutes with- 
out an enlightened public sentiment! Thus must it ever be 7 
' 'line upon line and precept upon precept. Tr Education pre- 
cursory of true liberty. 

Dipsomania is not alone in its work of deterioration. 
It is but one in a series — though perhaps the greatest that 
is leading us down. Tobacco, opium, chloral, etc., have 
their votaries and claim their victims. Vicious habit is 
hydra-headed, and requires the actual cautery of education 
and law. Future generations demand it as their life. 

Rapid child-bearing is confirmatory of this law. In all 
great efforts of nature periods of rest are required. It is seen 
in the field and forest. In frequent births the mother's rest 
is short or nil, her vital force is reduced, and the children 
suffer from lack of nourishment intra and extra-uterine. 
This is seldom seen in the typical American home. More 
often is seen the pale face and wasted form of the mother 
striving to rear an only child in luxury that she may be a 
devotee of fashion. This much is open. Withdraw the 
curtain — too often is seen a tri-annual abortion. 

Among a privileged few is sometimes seen the family 
physician. To whom shall w e attach the blame ? To the 
frail mother ? In the writer's judgment, nine-tenths of all 
abortions are procured at the instigation or request of the 
father. To whom the blame ? To all concerned Does 
such action affect a future offspring ? Yes— mentally and 
physically — and that in a deleterious way. It is crime in 
the sight of God and man. 

Sickness in either parent causes feeble offspring. A 
father who begets children during a convalescence or illness 
entails weakness in those children. A mother seriously ill 



—23— 

during gestation either aborts or the child shows an infirm- 
ity. Of course, there are exceptions, but the rule may be 
laid down as established, that no -party should become a 
-parent whose health is seriously impaired. 

Age in one or both parents modifies the offspring. The 
parents, not having reached maturity, it is of ten seen that 
the first or second child is feeble and subsequent children 
are strong. With the mother nature has hef limitation. 
Not so with the father. In marriages where there is dis- 
parity of years, care should be exercised. How often we 
See the old man marry the young woman ! Are the children 
vigorous ? That depends. Some men are young at seventy, 
while others are old at forty. Age alone should be no bar 
to offspring. 

To recapitulate, vice transmits defect: 

( To secure a 1 



Vice in 
Parents. 



Overwork, 
mental or 
physical. 



J Choice. 

J 

\ 

! Necessity. 



{ competence. 
| To obtain 
1 a living. 



Rapid child bearing, 
abortion, etc. 



Feeble 
}r Off- 
spring, 



Excess or ( Drink Habit and others, 
vicious 
habit. 

Sickness. 
I Age. 

The question may be asked, are the male and female 
equals in marriage? In accountabilit}^ to God and man, in 
the relations of life one to the other, they are equal partners. 
In the transmission of excellence, defect, similarity, etc., 
they may be equal partners, but at times there must be in- 
equality. In the early months of pregnancy the child is 
subjected to maternal impressions. During gestation and 
nursing the fetus or infant is living on pabulum distinctly 
the mother's. One would naturally infer the disposition 
and dyscrasia of the child to be largely of the mother. Is 
the inference the observation? An intelligent mother says: 
"When enceinte I longingly desired to attend dances. My 
husband thought it not best and refused to go. My only 
child from his boyhood until now has a mania for danc- 
ing.^ Another equally intelligent says: "I am ashamed of 



-2 4 — 

ni}' daughter's actions, yet am pleased she is trying- to do 
better, for I know it is all my own fault. She acts just as 
I did in the early months of gestation." 

There is an inequality. At conception the father in- 
delibly stamps an impress, and the being passes from his 
control. His work is done. Not so the mother. In gesta- 
tion the blood of the mother is the life of the child. So 
also in nursing. If the blood be impoverished the life of 
the little one is endangered. Abortion commonly occurs. 
The mother having a constitutional diathesis, the father be- 
ing in health, the diathesis is more certainly transmitted. 
Reverse the conditions; the diathesis is less certainly trans- 
mitted. The mother then has a greater power in transmis- 
sion than the father. This can be clearly shown only in a 
limited number of diseases. Maternal heredity is stronger 
than paternal heredity in syphilis. The family tree in tub- 
erculosis inclines heavily toward the mother. The fetus in 
utero. may be attacked with small-pox provided the mother 
is the subject of the disease. It is seen that while maternal 
impressions may affect all children it can only be presumed 
that maternal exceeds paternal heredity in all disease. Yet 
the presumption must ever be a strong one. 

Heredity is more or less a factor in gout, diabetes, 
mellitus and insipidus. The males having the disease are 
in preponderance to the females. This inequality does not 
show the male more readily transmits the diseases named, 
but that he is more subject to them. In fact, it rather 
shows the female the greater in transmission and the lesser in 
subjection. In that remarkable disease, hemophilia, this 
principle is still more strong. The mother transmits but 
does not inherit the tendency to hemorrhage, or, as a Dar- 
win might put it, the mother is a higher type of development. 

To formulate: 

i. The maternal impressions influence offspring. 

2. In all so-called constitutional or specific infectious 
diseases a transmission, if shown, is largely of the female. 

From the above we would deduce: A race or stock is 
most surely improved by selection of mothers. 



—25— 

I have dwelt somewhat at length on the incentive to 
marriage. Perhaps not wisely. In every community there 
are some who have great faith in human statute. If there 
be a beneficent change in any regard it must be by law. My 
view accords more to education. In a democracy, enlight- 
enment must precede statute. It is with this endeavor the 
apparently little incentive is shown. If one's inclination to 
a partner runs in a pretty face, amiability, wealth, etc.. 
how absurd to so legislate as to restrict him to poverty in 
feature, disposition and fortune ! 

But if it be clearly shown that certain actions invaria- 
bly produce certain results; that a life of temperance and 
virtue is excellent and transmits excellence; that a life of 
debauchery and vice is defect and transmits defect, how 
clear it must appear to every well-thinking man and woman 
that there is but one way to enoble and elevate mankind: 
To -practice virtue and shun vice. Virtue is the obser- 
vance of law, vice the violation of law — the law of our be- 
ing. Let us shun vice and cling to virtue in marriage. 



26- 



HEREDITY, 



John Milton, in "Paradise Lost," speaks of our first 
parents as "the loveliest pair that ever since in love's em- 
braces met." Milton is given to imagery, but who can 
think of a being more perfect than one fresh from the Crea- 
tor's hand, unsullied by environment, untarnished by sin? 
To me the creation should not only be lovely, but perfect in 
every particular. 

Looking back through the ages, I do not see Mother 
Eve with husky voice or disturbed respiration; neither do 
I see Father Adam with bacilli or tubercular nodules in the 
lungs. To me the conception is a perfect creation — perfect 
in form and in health. 

We are told our parents fell from this estate. The 
exact nature of the sin will ever puzzle theologians, but this 
much is certain: Adam and Eve violated law. "Of man's 
first disobedience and the fruit of that forbidden tree whose 
mortal taste brought death into the world and all our woe 
with loss of Eden." 

Then, as now, violation of law brings its penalty, ob- 
servation of law its reward. 

Evidently, the Adam of today is not the Adam of 
creation. 

Had we a complete account of disease since creation — 
embracing not only literature but observation — I firmly be- 
lieve the record would show no tuberculosis in the early 
centuries. 

All animate creation living wholly in the open air are 
free from tuberculosis. Our ancestors were nomads — wan- 
dering from place to place in search of game or pasture, 
sleeping under nature's canopy — life akin to animate crea- 
tion. The disease, in the early centuries, must then have 
been unknown, for we have no evidence that nature's laws 



—27— 

have in any waj r been modified or changed. 

If, then, no tuberculosis lurked in the tissues of our 
first parents, if the disease did not exist in the early cen- 
turies, how does it appear that one-seventh of the present 
mortality is due to its inroads? A frank question, and it 
should receive a candid answer. 

Tracing the genealogy of the patriarchs from Adam to 
Noah, we find a longevity unparalleled in the history of 
mankind. During this period two things stand out in bold 
relief — out-door life and length of days. These great object 
lessons may receive various interpretations. To me only 
one appears satisfactory: Out-door life — a sequel to crea- 
tion; longevity— a sequel of out-door life. Interpret them 
as you ma)', length of days and out-door life ever appear 
together. 

But it may be asked, is not immorality also associated ? 
Yes, it is — a depravity of mankind, but not a depravity of 
the patriarchs. 

An exuberance of animal spirits — with lack of self- 
restraint with the multitude — a consistent life of the few. 

We read of the general wickedness; of one hundred and 
twenty years given for repentance; of the flood, with the 
destruction of mankind. We also read "Enoch walked 
with God;" "Noah was a just man and perfect in his 
generations." 

A question now arises: Does heredity modify the aver- 
age life? In other words, does it make aught of difference 
to your grand-children or mine what our lives have been, so 
far as heredity is concerned ? I verily believe it does; that 
this has been true in all ages and in manifold ways. In 
primitive times the workings of a law on this line can be 
readily seen, but not as readily detected in the present gen- 
eration. Methuselah, the oldest man of ante-diluvian days, 
was the son of Enoch, who walked with God. Shem, aside 
from his father the oldest man of post-diluvian days, was 
the son of Noah, the perfect man of God. 

If we carefully examine, I think histo^ will show that 
not only do we inherit and transmit estates financial, but 



— 28- 

intellectual, moral and physical as well. In Enoch and 
Noah we see illustrated a law of retribution. The children 
inherit, the parents transmit, a tendency to virtue, plus 
length of days. 

To formulate our view: A father shortens or extends 
his days by vice or virtue. He transmits to his progeny a 
tendency to vice or virtue, minus or plus length of days. 
The same may be said of the mother. One parent being 
vicious and one virtuous, gives parents and children an 
equal footing in the race of life. Both parents being vicious 
or virtuous, makes the law doubly sure. It follows as the 
world becomes virtuous, longevity is increased, and vice 
versa. Of course, we are speaking only of the law of hered- 
ity or physical descent. 

We hold, then, as in a vase, the treasures given us. 
We add or take from as virtue or vice governs us. We 
transmit — how often less than we receive ! 

By heredity is meant prenatal inheritance, that which 
one receives prior to birth. Tuberculosis is used in its most 
comprehensive sense. Heredity in tuberculosis, then, 
means prenatal inheritance of an intractable disease. 

In all ages heredity has been recognized. This child 
looks like his father, that child resembles her mother. 
Physical resemblance to the biographer is heredity to the 
biologist. 

Physical resemblance is not alone, a mentality is trans- 
mitted. How often we see a family of children with men- 
tal traits or characteristics of their parents ! Yet this does 
not always pertain. 

Perhaps no better illustration can be given thar in the 
world-renowned Beecher family. Edward, the scholar; 
Harriet, the writer; Henry Ward, the orator — children of 
the eminent divine. A clear case of heredity in mentality. 
Yet today not one representative of that great family stands 
an equal in intellect to any of the four named. 

This brings us to a truth which I wish to indelibly im- 
press on the mind of every one. That while physical re- 
semblance and mental characteristic is transmitted, it is not 



—29— 

transmitted, so to speak, in one continuous stream, as with 
the river; there are water-falls and rapids and meanderings, 
so in heredity. 

Let no one claim that because heredity is not shown to 
be continuous it is no longer heredity. Heredity flows in 
no such perfect channel. On the principle of deviation in 
heredity and selection of offspring, Darwin has the great 
hold on the scientific mind. On this principle of deviation 
and selection the florist or stockman select the prettiest or 
best and make advances along this line. So in the thou- 
sand and one things we see around us. Ever since man's 
thoughts have been reduced to writing, perhaps before, 
certain diseases have been regarded transmissible from par- 
ent to child. Cancer, consumption and insanity belong to 
this class. 

Here is a field for the logician. If a healthy mentality 
be transmitted, why not a diseased mentality? If facial 
expression, why not other physical condition ? If tubercu- 
losis be a constitutional disease — and we believe it is — why 
not transmit the constitutional dyscrasia ? 

Thus, to the logician arguing from probability, constitu- 
tional disease is transmitted. Careful observation confirms 
this probabilit3 T . Insanity has been traced through successive 
generations in man} 7 families. Cancer sometimes shows 
itself in the offspring of the first generation, but more often 
in the second. 

Children of consumptives, though the environment 
be changed at birth, die oj this disease among other healthy 
children, born of other parents. 

We have already shown heredity travels in no perfect 
channel. It is therefore seen that the proof of heredity is 
complete. 

But, sa} 7 some, tuberculosis is not a constitutional dis- 
ease. It is a germ disease. The writer thinks differently, 
but for the sake of meeting on a common ground we assume 
you are right. 

The microscope makes main- revelations. By its means 



—30- 

scrofulosis and tuberculosis are declared one and the same. 
This has been verified in Germany. We accept it. Scrof- 
ulosis is modified by transmission, not so in tuberculosis. 
Thus it is seen, if the latter statement be true, the diseases 
which are declared one and the same are not one and the 
same. If one and the same they would alike be modified 
by heredity. 

Let me illustrate: My friend and I are walking in the 
country. I exclaim, ' 'What a lovely white house !" ' 'Yes," 
says my friend, "but that house is also black." You don't 
mean that same house is both black and white at one and 
the same time? That is just what I mean. Well, I fail 
to see it. My friend replies: "Were you ever in Germany ?' ' 
"No sir, I never crossed the North Atlantic." Well, that 
explains it. 

Ladies and gentlemen, are you satisfied with the expla- 
nation ? Would it not be wiser to call things one and the 
same that agree in every particular ? 

If these diseases be one and the same, heredity in tub- 
erculosis is rendered stronger than probable. 

Let us take another step. For many } T ears it was a 
moot question whether living bacilli could be transmitted. 
It is now universally agreed they may be carried by the cir- 
culation to various parts of the body and through the fetal 
circulation to the fetus itself. Ardent bacteriologists ex- 
claim: "Why look for heredity ? Here are seeds of disease 
carried to the prenatal offspring." 

Please reflect one moment. Did it ever occur to you 
that before a plant can take root there must be a suitable 
soil or condition of growth? Which takes priority, the 
plant or the soil in which it grows? Answer that question 
honestly and you condemn yourself. 

The moment you admit a growing bacillus at birth, 
that moment you tacitly admit heredity in tuberculosis. 
Heredity in tuberculosis is all we claim. 

We must not stop here. Imagine before you five ladies 
who gives intruction in painting on canvas. Your daughter 



— 3 i— 

wishes to acquire the art. Before selecting an instructor, 
s uppose you put a test question to each of these teachers. 
You hold a fabric in your hand and ask severally the color. 
Listen to the answers: Red, blue, orange, violet, indigo. 
What ?rises in your mind? One of two things — either 
these ladies are deceiving you, which is improbable, or else 
they do not understand the business they profess. What 
painter could instruct in blending three to five hundred 
shades of color who could not distinguish a primary one? 

You. have a son to send to college. You call before 
you five leading clinicians in the state and put to each the 
test question: What factor is heredity in tuberculosis? 
Listen to the answers: Nothing, little, much, a great deal, 
all. What arises in your mind ? One of two things — either 
these teachers are deceiving you, which is improbable, or 
el^e they do not understand the business they profess. 
Who can instruct except they zt'/io know? 

Ladies and gentlemen, have we been teaching error in 
the past? Come, let us acknowledge our fault, or rise in 
our place and refute what is said. 

We have not reached the pinnacle as yet. There is 
another step. With heredity in tuberculosis declared and 
demonstrated, an herculean work must be wrought. 

In marriage something more than minister or justice is 
required. It needs: 

i. General enlightenment in order to select. 

2. A physician's certificate by both parties prior to the 
marriage contract. 

3. A secretary of forensic medicine, with a universal 
marriage law. 

Ladies and gentlemen of the profession, when we rise 
to the occasion and demand these, they will be granted. 



—32- 



THE PRECEDENT STATE. 



When Robert Koch announced the discovery of the 
tubercle bacillus, its invariable association with tuberculosis 
and its consequent causative influence, the medical world 
were ready to accept anything as a working theory. Tuber- 
culosis had hitherto been an intractable disease. It was 
argued that when we have greater light or insight into the 
cause or causes of the disease, then we will be more success- 
ful in treatment. 

Some few physicians had anticipated the discovery. 
Others could see no reasonable objection to the conclusion. 
Figuratively speaking, the entire medical profession took off 
their hats and hurrahed. 

Had Koch discovered the same germ in health, deter- 
mined its invariable association and declared the presence 
of the germ the consequent cause of health, he perhaps 
would not have awakened the enthusiasm, but the truth 
uttered would have been equally clear. 

Tubercle bacilli are ubiquitous; are found in both 
health and disease. Growing bacilli are found only in dis- 
ease. A soil must precede the .growing plant. Hence, 
growing bacilli imply a precedent state. 

What causes the precedent state ? The error of Koch 
is a common one. Birds are seen on the growing plants. 
They are the supposed cause of failure in certain crops. 
The birds are killed. It is then found the birds were eat- 
ing the enemies of the growing grain. Tubercle bacilli are 
looked upon as the enemies of human kind. The prof ession 
have been largely engaged in their destruction in toto. To 
the writer it seems, should the extermination prove suc- 
cessful, tuberculosis would still exist. 

One thing should be plain to every observer: Health 
and the tubercle bacillus do not constitute disease. Some- 



—33— 

thing more is required, viz., the precedent state. 

What is the precedent state ? It is the condition of the 
individual that allows or encourages the growth of tubercle 
bacilli in his system. The tubercle bacilli are present in 
the bodies of every animate creature. They may be in the 
saliva, the blood, the tissue, etc. 

If the person be in health, or in other words, if there 
be no precedent state, these germs remain, or come and go, 
and cause no systemic disturbance whatever. 

Should the person inherit or should he acquire the pre- 
cedent state the living tubercle bacilli at once take root and 
flourish, for the temperature of the body is favorable to their 
development and growth. When these germs are found, 
growing in the human body the person is said to have tub- 
erculosis. Should one receive or acquire the condition fav- 
orable to the growth of these germs, this person may be 
said to have the precedent state. 

What is the precedent state ? Incipient tuberculosis — 
tuberculosis in the absence of tubercle bacilli. As elsewhere 
stated, tuberculosis may exist, though infrequent, in the 
absence of tubercle bacilli, but can never exist without the 
precedent state. 

In how many ways is the precedent state commonly 
received? In two ways — heredity and abeyance of atmos- 
pheric influence. 

Please explain in what way one inherits the precedent 
state? The precedent state is most commonly inherited 
through a tuberculous ancestry. The same state may also 
be inherited if one or both parents at conception, or the 
mother during gestation, be suffering from suspension of 
atmospheric influence, either from causes original or ac- 
quired. This, to some, may seem strange, but must of 
necessity be true. It is simply the violation of law on the 
part of the parents the precedent state transmitted to the 
children. 

To secure a healthy offspring it is showm to be just as 
necessary to live right as to marry right. A premium is 



- 34— 

therefore placed upon correct living and the taking of 
proper persons in marriage. To render this plain, let me 
illustrate: A mother or father has tuberculosis at concep- 
tion. Perhaps it is both parents who are afflicted with the 
disease. The children born die of tuberculosis. This 
seems plain. 

In the above, instead of tuberculosis, place the prece- 
dent state. The sentence then reads: One or both parents 
have the precedent state at conception. What would one 
reasonably expect as to offspring ? They would likewise 
have the precedent state. With children thus born, how 
easy to explain results. 

Many obscure cases are rendered clear by this explana- 
tion. We cite one by Austin Flint, Sr. ( "Practice of Med- 
icine," 1873): 

"Dr. Henry E. Paine, of Dixon, 111., illusirates a con- 
genital tendency without the evidence of inheritance. Mr, 
S. is fifty-seven years of age and in good health. His wife 
is fifty-two and well. No progenitors have- been known to 
die of tuberculosis. All the children, five in number, died 
with this disease between 1853 and 1861; their ages respec- 
tively being at the time of death twenty-three, twenty-five, 
twenty-four, twenty-two and twenty-three." 

In the absence of knowledge as to the occupation, mode 
of living, previous history of disease, etc., of Mr. and Mrs. 
S., the writer has the right to assume: 

1. Mr. or Mrs. S., one or both, had pneumonia prior 
to marriage. In common parlance, the)' were well, but 
each had a bronchial difficulty, or perhaps an hepatized lung. 
To what does this condition tend? Suspension of atmos- 
pheric influence — the precedent state. 

2. Mr. or Mrs. S., perhaps both, were engaged in an 
unhealthy occupation. Mr. S. in a tow-mill or grinding on 
an emery wheel ten hours per da}-, constantly spitting black 
dust from his lungs. Mrs. S. making shirts in close quar- 
ters fourteen hours per da}'. In either case to what would 
this induce? Suspension of atmospheric influence — the 



CO 

precedent state. 

3. Their manner of living was unsanitary. Mr. S. 
was a miser. He lived in one room and kept the door shut 
to save fuel. Mrs. S. was a crank and afraid of night air. 
She put the children to bed and covered their mouths to 
keep,out the cold or heat. To what would this condition 
of things tend ? Suspension of atmospheric influence — the 
precedent state. 

Under these circumstances the parents were well or in 
good health, but their progeny received the precedent state 
just as trul3 r as though both parents were suffering from 
tuberculosis. Result — the children died of tuberculosis. 

The result would have been the same had the parents 
lived in our generation. They might have indulged in 
present scientific fads — the injection of tuberculine to cause 
sloughing of diseased tissue: the placing of sterilized gauze 
over all apertures for ventilation to prevent the entrance of 
microbes, so fatal to children; or, were they familiar with 
present ideas in the fatherland: the securing of artificial im- 
munity. The writer believes that under any or all of these 
so-called cures or preventives the children would have died 
as' the}' did, of tuberculosis. 

It is not cure, but prevention, that will ultimately con- 
trol the disease — prevention, not by injection, but by con- 
trolling the -precedent state. 

But hold ! Why not assume Mr. S. had a right in- 
guinal hernia or Mrs. S. scarletina in infancy? The reason 
is obvious. Nothing is assumed that does not naturally 
lead to the precedent state. 

Does it necessarily follow that one having the prece- 
dent state must die of tuberculosis ? It does not necessarily 
follow. It must be remembered the precedent state is the 
first link in a great chain. If there be no first link the 
chain will never be formed. If the first link be present, 
others are readily added. In a typical case will other links 
be joined. That depends. For the individual it must ever 
be a constant battle. 



-36- 

Let us endeavor to make this clear- Mr. A. has the 
precedent state. The soil in his system is read}- for the 
seed. The tubercle bacillus, the seed, is constantly present. 
What is the probability ? The seed will at once take root. 

How best to proceed ? There are three methods; 
i. To get away from the germ. 

2, To get away with the germ. 

3. To leave the germ alone or rid one's self of the pre- 
cedent state. To use terms more consonant with science; 
( 1) Germ exclusion; (2) germ destruction; (3) germ non- 
intervention, 

1. Dr. W. Van der Heyden, a bacteriologist of Japan, 
has recently built a microbe-proof house. Its manner of 
structure, dimensions, etc., are known to many. We 
t\ ill not refer to these, Japan is young in science. Science 
in theory and science in practice are two things. Suppose 
the germs cause the disease; the house perfectly excludes 
the germs. It is evident the doctor cannot always remain 
in his house. He must be a live M. D. He must attend 
to business. Will he take the house with him constantly ? 
He has a field to cultivate. Will he kindly loan the house 
to his servants while at work ? He has a large manufactory 
in which thousands of hands are employed. Will he in- 
clude this establishment in his microbe-proof house? If 
not, why not? The doctor will find theoretical science is 
not practical. 

We now introduce another class. In this we have the 
intellect of our land. Says an authority; Whenever I see a 
case of incipient tuberculosis I exclaim: "Haste to the 
mountains 7? Escape for thy life !" The writer asks why 
so great haste. To get away from the germs. 

"Come, let us reason together. " Suppose you stand 
before two bare rocks, the one on the right hand, the other 
on the left. On the one rock is placed one kernel of wheat. 
On the other rock is placed one thousand kernels of wheat. 
The conditions of growth, light, heat, moisture, etc., being 
the same, which would germinate the sooner, the one kernel 



—37— 

or the one thousand kernels ? The writer asks any man in 
the land to show a difference in germination. Why do you 
hasten your patients to the mountains ? To escape from 
the germs of disease. What foolishness ! 

Do not germs exist in the mountains ? They are not so 
plentiful in the mountains. If germs cause the disease, if 
the condition of the system be favorable to their growth, 
are not a few germs all that is necessary ? 

If absence from germs be all that is required, please be 
consistent. Why not lease Dr. Heyden's microbe-proof 
house? The truth lies here, the mountains do benefit, but 
the benefit does not consist in absence of germs. It con- 
sists in more perfect aeration of the blood. In other words 
the more perfect aeration drives away the precedent state 
and the germs do not grow. Let this be remembered. 

To recapitulate: (a) Science has no practical method 
of germ exclusion; (b) had science such method it would be 
useless unless germs cause disease. 

2. Germ destruction. It is true germs may be de- 
stroyed. There are germicides in abundance, and some of 
them very efficient ones. It is also true that science knows 
no method of total germ extinction. Had we such method 
it would be useless unless germs cause disease. The writer 
thinks the latter stands not proven in tuberculosis. 

3. Germ non-intervention. This is the author's own 
method, and, he thinks, has the merit of being practical. 



■38- 



WHOM TO MARRY. 



. So long as medical men firmly believe the germ theor3 r 
of tuberculosis, so long there will be no true progress in 
prevention and control of this disease. 

So soon as we grasp the idea of a precedent state or 
condition in the individual prior to the advent of the bacillus 
so soon we take the first step in prevention and control. 

There can be no definite action until there is clear ap- 
prehension. 

If one only cares to look he can readily see the tubercle 
bacilli do not grow in the normal or healthy tissue. It is 
always in the abnormal or unhealthy tissue they take root 
and flourish. 

Tubercle bacilli, then, differ from the ordinary parasites 
that infest the animal and vegetable kingdoms. 

Again, a recognition of heredity in tuberculosis — a per- 
ception that something is inherited other than an active 
bacillus— likewise leads to investigation that will enlighten 
and aid in controlling the disease. It is into a channel of 
this character we desire to enter at this time. 

We have elsewhere stated, "Abeyance of atmospheric 
influence, in whatever way induced, causes a depraved tis- 
sue or dyscrasia, through which the tubercle bacilli enter 
and grow." In other words, a law underlies the formation 
or creation of the precedent state or condition. 

In heredity the precedent state or condition of the off- 
spring is received direct by parental transmission at con- 
ception, or more slowly, through the mother during intra- 
uterine life. 

At conception the father's work is complete. If the 
father at this time have a constitutional dyscrasia, or if he 
be violating a law of his being so as to impair his organism, 
the fetus will certainly show this dyscrasia or violation at 



—39— 

birth or in after years. The same may be said of the mother. 

If both parents have this dyscrasiaor are violating law, 
the result named to the fetus is doubly certain, or, perhaps 
better, doubly strong. 

At conception the work of the mother is incomplete. 
During gestation, if the blood of the mother be impure or 
impoverished, it will certainly cause the death or deteriorate 
the health of the intra-uterine offspring. This statement is 
confirmed by every -day observation. It is therefore seen 
that the character of the offspring must be largely deter- 
mined by the health of the mother. 

If we are clearly understood, the precedent state or 
condition is found in two classes: 

i. Those who in any way, suspend atmospheric in- 
fluence. 

2. The fetus or intra-uterine offspring under the con- 
ditions named. 

Or perhaps it is rendered clearer by saying the preced- 
ent state or condition is received in two ways: 

i. Suspension of atmospheric influence. 

2. Heredity. 

While the law of formation or creation of the precedent 
state or condition may be active in the ancestry, it is neces- 
sarily inactive in the prenatal offspring, -per se ; hence a 
question now arises: 

How do you reconcile a condition induced by law and 
the same condition induced by heredity in which this law is 
held in abeyance? 

An illustration perhaps will render this clear. Along 
the ocean coast there are tides. These tides are governed 
by law. A prevailing wind increases or diminishes the tide 
at any point of the ocean shore. Heredity is a prevailing 
wind. Heredity may increase or diminish the death rate 
from tuberculosis. 

Eliminate all disturbing elements and there would be 
uniformity in tide. Eliminate disturbing elements in tub- 
erculosis, of which heredity is one, and there is uniformity 
of action in law. There is this difference: The tide may 



-40— 

never be governed; heredity is, in many instances, controlled. 

Having tried to make plain the conjoint action of law 
and heredity in tuberculosis, showing that in some instances 
heredity aids the action of law and in others militates against 
its action, let us now proceed to discuss a topic in which we 
all are directly or indirectly interested, viz., marriage. 

A certain farm writer has compared marriage to the 
garden of the farm—in many ways a beautiful and happy 
comparison. The garden, a mere patch, highly cultivated/ 
yields the choicest and most luscious fruits; marriage, a 
fraction of duration, happily consummated, yields an off- 
spring the joy and jewel of our lives. The garden returns 
according to seed, soil and degree of cultivation; marriage 
returns according to parents, mother and care in after years, 

Let there be no mistake. Nature is not mocked. As 
the seed, soil and cultivation, so the fruitage. 

In marriage so many questions are involved that it 
seems like complication to add other conditions to those 
already known. But if the future welfare of a people de- 
mand care in selection, it must be granted that no care is 
too great. 

From time immemorial the man has sought the woman. 
It is the man who "pops the question." The woman 
chooses in the negative — receives or rejects. Whether this 
order should be changed, whether the change would be ben- 
eficial, are questions we w T ill not discuss, but there is one 
thing on which the writer expresses himself, viz., every 
man or woman's family history should be a public record. 

As one in the purchase of real estate goes to the public 
record to examine the title, so every one should have the 
right to examine a record of heredity when selecting a 
partner for life. This may be deemed foolish, but it is a 
foolishness beneficial to mankind. 

Let me illustrate. You select a partner. Whether 
guided by impulse or choice in the selection, she pleases you 
and the union is joyous but for one thing — in a number of 
years, more or less, usually less, the wife dies of tubercu- 
losis. Yet more — the children have a history of tuber cu- 



—4i— 

losis. Perhaps this is the record of a husband. The result 
to him is just the same; not always so to the children. 

All observers agree that tuberculosis travels most read- 
ily through the mother. Why ? Because it is the mother 
who sustains the fetus during gestation. A diseased condi- 
tion of the mother if therefore more liable to be transmitted. 

Father and mother are equals in conception, unequals 
in gestation. 

As social custom gives man the province of selec- 
tion, observation should teach him to select wisely. As 
social custom prescribes woman an acceptance or rejection, 
she should be taught to accept or reject wisely. 

WHOM TO MARRY. 

Let no man propose to a woman who has a clear family 
history of tuberculosis. Let no woman readily accept a 
man with a clear family history of tuberculosis. 

While the worn an, under certain conditions, as vocation, 
environment, etc., ma} 7 accept a husband w T ith a hereditary 
taint of tuberculosis, it is best for her not to do so. Under 
no circumstances should one secure a wife w r ith a tubercular 
history. The progeny in the former case is generally free 
from the disease, but not always so; the progeny in the 
latter case are seldom or never free from the disease. Of 
course there are exceptions. 

Intermarriage of tuberculous subjects should be pre- 
vented by legal enactment. 

What more can we say ? In prevention of tub erculosis 
education and restraint should be the watchword. In all 
theorizing, practical results should be the object or aim. 



— 4 2- 



EDUCATION. 



We must educate. We must educate. This has been 
the watchword in our country since its early history. A 
commendable watchword. Washington, Franklin and 
others expressed the same in like words. 

Some restrict education to the acquirement of knowl- 
edge. It is more than this. Education has for its object 
the development of the powers of man. This development 
may be along many lines of work. It truly includes orig- 
inal work. People must be educated even to think. 

It does not follow, then, that he is best educated who 
has the most information in store; the largest library. 
Rather he is best educated who best reasons from cause to 
effect; who, while having the requisite knowledge to in- 
quire, has also the ability to. generalize. 

We speak thus particularly, for many think education 
and acquisition of knowledge are synonymous. There is a 
distinction and of ttimes this distinction makes the difference 
in mankind. _ 

On no topic do we more clearly require education than 
on the one before us. Our mental shelves are laden with 
acquisitions, but in the writer's judgment little education is 
present. False notions and ideas have become so blended 
and intermingled with actual knowledge that much is taught 
which lies in shadow-land, that cannot endure the test 
of time. Education should lift us through or above the 
shadows into the reality; open the veil before us to let the 
sunshine of truth enter. We must educate, but we must 
do so as to awaken latent thought, cultivate original re- 
search, and teach every man to think independently. Then 
education will be of value. 

Today there is a germ theory of tuberculosis. Truly, 
it is a theory. Is it anything more? We think not. Med- 



—43— 

ical works are filled with disquisitions on the tubercle bacil- 
lus, the so-called cause of tuberculosis; when, where and 
how the germ is detected; its significance when found or 
when not found; the procedure, if latent or growing; the 
way to capture, isolate and cultivate; the best microscope 
to look at, after or into the invader, etc., etc., etc. 

This is all very well so far as it goes, but it seems to 
the writer like superficial cultivation. We need occasion- 
ally a subsoiler that will strike deeper and bring up that 
below into the sunlight, 

A number of years ago an enthusiastic agent was intro- 
ducing a certain kind of honey bee. Among the many 
points of excellence of this particular bee was its size, hard- 
iness and qualities as a honey collector; so large no other 
bee would quarrel with it; so hardy the climate had no 
effect upon it; so great a worker it did not require feeding. 
He dwelt on these points with a fervid oratory. A hive of 
peculiar construction was then introduced. It excelled 
every other in that the holes or exits were so small that no 
enemy of the bee tribe could enter. The hive was abso- 
lutely safe from all invaders. At this juncture an old 
farmer arose and asked how so large a bee could enter so 
small a hole. The agent was evidently master of the situa- 
tion and blandly remarked this was no business of his what- 
ever; this is the bee's look-out. 

After so much talk on the tubercle bacillus, what it 
does and what it does not, the writer is somewhat in the 
position of the old farmer, and asks how the tubercle bacil- 
lus enters the healthy organism. The reply is equally log- 
ical: "This is the look-out of the tubercle bacillus." 

This seems the only answer ever given by the bacter- 
iologist. Is there no other? We think there is. The 
fighting qualities of the tubercle bacillus, like the Span- 
iards, is vastly over-rated. Each desires little to do and 
plenty to eat. Neither would forcefully enter a harbor for 
temporary or permanent rest. How, then, do the tubercle 
bacilli gain a footing ? By falling as a seed by the wayside 
and simply taking root; by eating the first food that pre- 



—44- 

sents and satisfying a natural craving or hunger. The 
tubercle bacillus is not seeking whom it may devour. It 
never goes out foraging, but is everywhere present, and 
wherever there is suitable soil, simply grows. It is evi- 
dent that a soil must precede the growing organism. 
Every biologist will acknowledge the accuracy of this state- 
ment — first the soil, next the organism and lastly the 
growth. 

Say not, then, that the tubercle bacillus is a parasite. 
It is not a parasite. It is a vegetable organism, taking root 
in a fertile soil. The soil precedes, is prepared for and 
nourishes the growth of the organism. What is the mission 
of the organism ? That of a scavenger. It takes up the 
old, useless and worn-out tissue that has no further virtue 
in the economy. When this effete tissue is wholly taken 
up the organism disappears. So long as this tissue forms 
the organism thrives. 

In tuberculosis an animal debris is continually present. 
Suspension of atmospheric influence causes the debris or 
worn-out tissue. Remove the suspension and you at once 
remove the formative process. No formative process, no 
tuberculosis. This information may seem strange; may not 
be found in standard works; yet is nevertheless true. 

The tubercle bacillus is not the cause of tuberculosis. 
There is another cause, viz., suspension of atmospheric in- 
fluence in whatever way induced. 

With this truth clearly before us and ever in mind, no 
fear need be entertained regarding the tubercle bacillus. 
It is perfectly innocent and may be so considered by all. 
We are living in troublous times. The outlook is brighter. 

I^et us gird on our armor, fight the battle with courage 
and take heart for the future. 

A crisis is upon us. Men of science have laid out the 
metes and bounds of knowledge in this disease. ' 'Thus far 
thou shalt go and no farther." Men of observation, per- 
haps equally wise, see no progress — rather decadence; ob- 
serve a weakness or inefficiency in present methods. They 
boldly ask why this educative empty nothingness. Men of 



—45— 

the schools who hold place, perquisite and power ask why 
this cadence of invective. Each in his way maintains his 
right — a battle for supremacy. 

It becomes every thinking medical man to use his in- 
fluence for the right, whatever may betide. Disease stalks 
rampant through the land. Servitude, if of value, is hon- 
orable. Serfdom to a theory is dishonor. In this disease 
the gall and bitterness of bondage are severely felt. Are 
we thinking men ? Let us feel the chafing of a foreign yoke 
no longer. 

What is tuberculosis ? Says one: "An infective dis- 
ease caused by a germ." Says another: "A systemic dis- 
ease caused by violation of law." One says: "No tubercu- 
losis without a germ of disease." Another says: "No tub- 
erculosis without violation of law." One holds a vegetable 
organism or plant growth as necessary. Another holds 
violation of law or ill- ventilation as necessary. No tubercle 
bacillus, no tuberculosis. No suspension of atmospheric 
influence, no tuberculosis. One tries to catch or antagonize 
a bacillus. Another tries to correct or modify present action 
of law. One could prevent disease if no tubercle bacillus. 
Another could prevent disease if no violation of law. One 
says: "Give us more time; it is a question of science." 
Another says: "Give us a hearing; it is a question of com- 
mon sense. ' ' One stands entrenched with shield and banner 
displayed. Another stands in the open, fearing no defeat. 
What medicine can be more practical than preventive 
medicine ? 



46- 



FOOD PRODUCT. 



No factor is more conducive to trie well-being of a peo- 
ple than diet or food product. If we turn to history and 
seek those nations which have secured the most lasting re- 
gard or aggrandizement, we invariably find a people well 
fed. Per contra, should we seek the tribe or race lowest 
in the scale of existence, whose history — if so it may be 
called — lies in the unwritten legend or tradition, whose 
home is migratory and uncertain, we find an insufficient 
diet, with alternate plenty and privation. 

So true are these statements, that brawn and brain 
work most harmoniously and efficiently when food product 
is adequate to the animal economy; so true are these state- 
ments that, other circumstances being equal, given the diet 
for five consecutive generations f the condition of a people 
may be fairly determined. 

No better illustration can be given than in the exam- 
ples of Great Britain and India. 

Great Britain, synonym for strength, has fought with 
nearly every nation of the earth, and today controls a do- 
main on which "the sun never sets." , Great Britain, a 
land of liberal diet. 

India, synonym for weakness, vast in area, population, 
resources and willingness to pay taxes; vast in little else, 
controlled by a few thousand alien soldiers. India, a land 
of restricted diet. 

Exchange the food product for five generations, think 
you their relative strength would remain the same ? 

As with the nation, so with the individual, though less 
marked. Show me the man or woman whose whole life 
diet is scant or insufficient, and I will show you the intel- 
lectual or physical weakling. Bone, brain and muscle are 
built on food ample in quality, quantity and variety. When 
little Oliver Twist calls for '"more" it is no idle, childish 



—47— 

whim or folly, but is au urgent call of wronged nature. 
The soup is too thin, the quantity too small, and the qual- 
ity deficient. Are there any little children in this land of 
plenty who are calling for more? Examine closely before 
you say no. 

Thus far we have spoken of normal or wholesome food 
product. But at times a staple production fails, or is defec- 
tive or diseased through climatic or other causes. A people 
dependent on one production must then face starvation or 
become enervated through diet. The famine in Ireland 
through failure of the potato crop, or local out-breaks of 
ergotism through eating black rye, etc., are familiar exam- 
ples. Again, a food product may be defective in that it is 
improperly cared for. Mouldy hay or musty grain must 
impair the health of the animal that eats them. Over-ripe 
fruits, partially decayed vegetables or meats improperly 
kept must cause sickness to the consumer. In regard to a 
food product there is only one royal way — to select only 
the best. 

Of food product there is only one with which we all are 
perfectly familiar; only one that fulfills every indication, 
meets every want, and in truth is ideal — pure milk. Per- 
fect and familiar food as milk is, no article has been more 
used and misused. Today it stands eulogized and con- 
demned. One fact remains — -pure milk a -perj ect food. 

The purity of milk is affected by intrinsic or extrinsic 
causes. In other words, milk ma}' be changed during se- 
cretion or after it is withdrawn. Of the various changes 
that take place after milking we will not refer, but simply 
state that they all may be prevented for a longer or shorter 
period by roper sterilization. Various apparatus are on 
the market and perfection in this regard seems to be reached. 

While sterilization is thus regarded so favorably there is 
one thing it can not do, as will shortly appear. 

Of the various changes that take place at or during se- 
cretion we wish to speak more particularly. 

i. It is asserted by high medical authority that tuber- 
culous animals secrete milk containing bacilli. So far as 



- 4 8- 

known, no one argues their presence in the milk. Seeing 
is believing. 

2. That by sterilization the bacilli may be killed and 
the resultant milk rendered a perfect food. 

In the judgment of the writer this statement is as near 
prevarication as is Bill Nye's description of a cyclone. It 
contains some truth, but most of it is mythical. That 
bacilli may be killed by sterilization or that there are cy- 
clones, no one denies, That tuberculous milk may be ren- 
dered perfect food by sterilization is as mythical as Nye's 
description. 

There are two things of which American physicians 
can justly feel proud — practical ideas and good common 
sense. Suppose during the famine in Ireland that the 
Americans, instead of sending a ship-load of corn, had sent 
a ship-load of sterilizers. Would the famine have been 
staid ? Suppose during an out-break of ergotism some one 
should suggest sterilization. My dear sir, we do not eat 
uncooked rye. It is ground, made into loaves, and sterilized 
in the oven. The* people still die. No sterilization will 
render a diseased grain or a partially decayed potato perfect 
food product. 

Fondness of a bargain is likewise American. Suppose 
I have five tons of mouldy hay. It is sterilized after the 
most approved German method. Is there a physician in 
the land who will pay a full market price for this hay ? 
The hay is an imperfect food before a mould fungus starts. 
Killing the mould fungi does not restore perfect hay, 

Milk secreted by a ticbercu/otis animal is a diseased 
product — a diseased -product before bacilli are found. 
Killing the bacilli by sterilization does not restore a -per- 
fect milk 

Milk is a secretion — an elaboration — of principles from 
the blood. If the blood be pure, the milk is pure and vice 
versa. 

It is known that nervous impressions increase, dimin- 
ish or vitiate the milk flow. It is known that the milk of 
a syphillitic is poor in quality, and should be nursed only in 



—49— 

exceptional cases. 

What shall we say of the milk of an animal suffering 
from a constitutional disease ? To the writer, it seems a 
fallacy is foisted unwittingly on an intelligent public. 

Are there any little children in this land of plenty who 
are calling for more ? Herein lies a secret of the fifty per 
cent, of mortality under five years of age. Believing this, 
could you conscientiously recommend condensed milk for 
children, gathered as it is from unknown sources? 

Poor as are all artificial infant foods — in that they do 
not contain the elements of nutrition — they are superior to 
commercial condensed milk, in that they do not contain the 
elements of disease. 

Some one may ask what is the chemical difference be- 
tween diseased and healthy milk. Some one may likewise 
ask what is the chemical difference between a diseased and 
a healthy potato. Cook them and your three-year-old child 
will see a difference. Use the two kinds of milk and you 
will perceive a difference. 

Have you ever said to a mother: "You must not nurse 
your infant. You are in ill-health. The milk is a diseased 
product." 

In the moral as well as the phj^sical world no man 
should find fault with present conditions unless he be able 
to point out a better way. 

If pure milk be the only perfect food, if the infant 
human race must live on milk, the way to obtain pure milk 
is the desideratum of the century. 

i. We must have healthy animals. 

2. Animals must conform to hygiene. 

3. Every precaution must be taken to keep milk pure. 
How shall we obtain healthy animals ? What says the 

New York Health Board? "Use the tuberculin test and 
kill all diseased ones." To the writer this seems like cross- 
ing the valley of Lethe on the bridge morality. The bridge 
— a very fine structure — stops in the ?niddle of the river . 
In less than five years New York will again have to adopt 
the scientific method. 



— 5o- 

While removing the diseased animals would it not be a 
higher wisdom to secure a healthy progeny by selection. 
Animals must conform to hygiene. 

It is astonishing how inconsistent we are. Mothers 
must be very careful of diet, etc., etc., while nursing in- 
fants. Cows are allowed to be crowded in filthy stan- 
chions, eat mouldy hay, drink stagnant Water, without air, 
exercise or sunlight; milked at all hours, the milk delivered 
twenty-four hours late, is sterilized and pronounced perfect 
baby food. 

The man who sells rotten bananas and robs you of your 
child is no more guilty than he who thus cares for bis cows 
and spreads disease and death. They should alike be held 
amenable to law. 

Kvery precaution should be taken to keep milk pure. 
Herein lies a field for sterilization. 

Look over the able articles written during recent years 
and you will readily glean a concensus of belief as follows: 
(a) Diet causes tuberculosis; (b) diet cures tuberculosis; 
(c) diet prevents tuberculosis; (d) the same article of food 
taken in the same manner acts in the three ways mentioned; 
viz : a, b and c, at the same time, (e) Statistics prove all 
this. Our ascertained facts must be renovated. There is 
certainly something wrong. 

In what does the wrong consist ? We believe it con- 
sists in a false conception of the nature of the disease, 
tuberculosis. 

We are taught tuberculosis is an infective disease 
caused by the tubercle bacillus; infective in the sense that 
one takes the disease from another; caused, in the sense 
that growing bacilli are commonly found in the disease. 
So long as these ideas entertain and hold there can be 
little true progress. To progress there must be a radical 
change or rather interchange of ideas. Take the common 
food product, butter. No article of commerce is in more 
common use or contains greater number of tubercle bacilli. 
If present views be correct every time we partake of butter 
we are infecting our system with tubercle bacilli or causing 



—51— 

tuberculosis. 

On observation it is evident: (a) That multitudes of 
people eat butter who do not take tuberculosis; (b) that 
tubercle bacilli do not take root in the health}' human 
organism. Hence (c) butter does not cause tuberculosis 
only in certain diseased conditions of the system. 

It follows: (a) Those having this diseased condition 
should not ed't butter; or (b) should eat butter free from 
tubercle bacilli. 

The question now arises, what is this diseased condi- 
tion of system ? 

How does it arise or how is it caused, and in what way 
may we prevent it ? 

On close observation it is seen only those animals allow 
the entrance of growing bacilli who in some way have sus- 
pension of atmospheric influence. If there be no suspension 
of atmospheric influence there can be no tuberculosis. 

It is then a question of suspension or non-suspension of 
atmospheric influence, and not a question of eating or not 
eating butter; not a question, -per se whether tubercle 
bacilli be preseut or absent in said butter. If the reasoning 
be correct, instead of a microscopial examination of butter 
to determine the presence or absence of tubercle bacilli, we 
should examine the family histor3 r or environment of the 
party eating butter. 

The same reasoning may be applied to milk. 

No greater fallacy exists than that milk causes tuber- 
culosis. Yet it will take years to teach the public to think 
otherwise, because we are so imbued with the germ theory 
of disease. The truth will at last prevail. Some time, sooner 
or later, we will know better. In the accepted way, we 
have spoken of diet as causing tuberculosis. Let us now 
refer to diet as a cure of the disease. It is observed by all 
clinicians that tuberculous patients recover most rapidly 
who have good digestion and assimilation. They w T ho can 
eat food and digest it, increase in flesh and put on a healthy 
appearance. They are certainly getting better. Per con- 
tra , the}' who are scant eaters, or they who have poor di- 



—52- 

gestion gradually lose in flesh and become worse. They 
lose in flesh from lack of nourishment and from the waste 
constantly going on. Herein lies the secret, if there be 
one, of the so-called cure. 

Diet of food, rich in fat, if readily assimilated, restores 
the waste constantly going on. Does it cure? 

It is' certainly an efficient aid in cure. Should the 
cause of the disease be steadily at work, np true cure is 
affected by diet. 

Does diet prevent tuberculosis ? That there be no mis- 
apprehension we refer to one or two writers as expressing a 
belief that it does. Is this true? "Next to a life in the 
open air, perhaps even more than that, the question of food 
is of the utmost importance in the prevention of tuberculo- 
sis, as well as in the treatment of the disease." — Youth's 
Companion, March 31. 

Speaking of hygienic treatment: "Of equal importance 
with pure air is the selection of proper food and its diges- 
tion and assimilation," etc. — Lancet-Clinic, Feb. 5. 

These writings are selected simply to show the trend of 
modern instruction . They express what is being taught on 
every hand: That proper food is equal to pure air as a pre- 
ventive of tuberculosis. 

The writer thinks not. Proper food or diet per se will 
never prevent tuberculosis. Pure air per se will ever pre- 
vent tuberculosis. Taken together there is no equality. 

Improper or insufficient food causes inanition. 

Impoverished or impure air causes tuberculosis. 

In inanition there may be or there may not be tuber- 
culosis. 

In tuberculosis there is always inanition. 

To briefly summarize: 

Diet does not cause, cure or prevent tuberculosis. If 
true, how can the action of a, b and c take place at one and 
the same time? If true, are tubercular statistics of value? 

What is tuberculosis? A constitutional disease, de- 
pendent largely on the evils of civilization and governed by 
the following law: The death rate from tuberculosis is in 
direct ratio to suspension of atmospheric influence. 



—53" 



THE CAUSE OF TUBERCULOSIS, 



United States Indian Service, 
Yankton Agency, 
Greenwood, S. D., August 24, 1898. 

Dear Doctor — I have read with great interest your 
article in the last number of the Medical Record. I have 
held your views for some time. I have in my experience 
the best illustration imaginable. 

I have attended the Indians both here among the Sioux 
and in Idaho among the Bannocks. I have known many 
Agency physicians and have talked with them. All agree 
that the older Indians say they did not have consumption 
among them when they lived in teepees and in the open air. 
But as civilization advanced among them the government 
has constructed log cabins and small frame houses for them, 
and they have given up the teepee except a short time in 
the hottest weather of summer. Now we have consump- 
tion the most prevalent disease. More than half of the 
deaths are from it. 

In examining Indian children as to their physical 
fitness for school it is almost the rule to find tubercular 
glands in the neck or some evidence in the lungs. The 
joints of Indians and mixed bloods are rarely attacked by 
tuberculois. 

These houses are mostly low, having one room; many 
are log cabins with dirt floors, sealed as tightly as possible ; 
the whole family living in this one room, and except in 
summer, cooking there on a large cook stove, heating the 
poorly- ventilated room to furnace heat, and after perspiring 
freely, going into the cold air. They are in the transition 
stage between savagery and civilization, mentally, morally 
and physically. This may account in some measure for the 
fearful hold this disease has on them, but I think tubercu- 
losis came with the house and ' 'suspension of atmospheric 



-54— " 
influence." 

Would it be wise to embody these thoughts, rambling, 
in a paper to help prove the great factor, suspension of at- 
mospheric influence ? 

I trust you may find some interest in these remarks, 
and I thank you for the new light your valuable paper has 
thrown on the subject for me. 

Believe, me, I am, very truly yours, 
Geo. F. Pope, M. D., Agency Physician. 

The above letter is self-explanatory. The article re- 
ferred to is found in the New York Medical Record of 
August 20, 1898, and is one of a series now numbering 
nearly forty. In these papers it has been the endeavor of 
the writer to express a continuity of thought and establish 
the law of tuberculosis. 

The law and the proof of its existence may be found in 
the Transactions of the Ohio State Medical Society (1893). 
So far as known no writer has attempted to controvert this 
fa ^ Its author stands its champion and advocate. 

To some it may seem strange that disease obeys law. 
Why not? Is not everything in this universe subject to 
law ? Why not disease ? 

Malaria, the writer feels assured, is governed by law. 
He has so expressed himself in one or two published articles. 
So that whatever view may be entertained as to the Plasmod- 
ium of this disease, please remember there is a law of malaria. 

Cholera, the writer has long thought, is governed by 
law. The visitations of this disease are no mere chance 
visitations. Law underlies them in every instance. 

So we think in every disease there will be found a law. 
Knowing the law, we can the more readily control the 

disease. 

Medicine of the future will be largely preventive. In 
the past the effort has been to find a remedy that will suc- 
cessfully combat the symptoms of disease. This is well. 
We have a multitude of such remedies. In the future it 
will be the desire to determine the law that governs dis- 
ease. This will be better, in that we can the more readily 
predict the time, place and extent of disease zones. Then 
there will be less confidence in remedies and a greater con- 



—55— 
fidence in means cf prevention. All hail this happy day ! 
It will surely come. 

Malaria is a disease whose treatment is fairly well 
understood. In its worst type it is not considered a dis- 
tinctly fatal disease. It is largely enidemic and its visita- 
tions are under control. 

Cholera belongs to other climes, and visits our land 
only under certain conditions and {after the lapse of years. 
With this disease we are not so much concerned. 

With tuberculosis the case is different. This disease 
is with us at all seasons and is extremely fatal. It takes 
our nearest and dearest friends, and when once its grip is 
felt its hold is seldom relaxed. It is a strangely fatuous 
disease. The patient is ever having a slight relapse, never 
worse, gradually improving all the time, and dies in this 
belief. 

There is another fact. No treatment is of lasting 
benefit. The physician calls it a bronchitis, assures a cure, 
receives a retainer, until he who runs may read tuberculosis. 

Nor is this act of the physician a mere love of gain. 
At first he believes what he says. He then modifies his 
prognosis as the disease advances. At last, for fear of com- 
petition, he holds his patient by mere force of will. He 
says in his heart: "I know you cannot be cured, but you 
must not be a patient of my competitor. ' ' What a shame i 
Tuberculosis thus advances year by year without one 
thought of cause or cure. Of course we are speaking of the 
rank and file of the profession. What shall we say of them 
whose title, dignity and rank but belittle the name they 
bear? "Miserable comforters are ye all." The classic lore 
still guilds the page, but blinds the intellect. When will 
ye be wise ? 

In the Medical Review, October 5, 1895, the writer 
recalled the words of the Psalmist: "He brought them 
forth also with silver and gold; and there was not one 
feeble person among their tribes." The estimate being 
variously given as from one to two millions, where could 
we find such a people on the face of this earth today ? Cer- 
tainly not among the civilized. 

He also recalls the statement of the classic historian, 



Lossing. Speaking of the Indian tribes embracing the 
greater portion of the north temperate zone, L,ossing says: 
"Physical deformity was unknown, and there were few dis- 
eases among them. ' ' Could tubercul osis have been present ? 
We think not : 

Prof. Osier is also referred to in the same article as 
saying: "No race is immune. The Indians of this conti- 
nent are very prone to the disease. Matthews, whose ex- 
perience with the native race is large, states that the dis- 
ease is on the increase among them. 

The writer asks, how is the disease on the increase 
among them? As they come iu contact with civilization. 

Listen to Osier's own words, same page (Practice of 
Medicine, p. 185, 1892): "The death rate in the older res- 
ervations, as in New York, is three times as great as in 
Dakota." That is, the death rate is three times as great 
where the Indians are in contact with civilization three times 
as long; or, in other words, the death rate is in a direct 
ratio to contact with civilization. Could any testimony be 
more conclusive ? 

Carefully read the above letter, and you have the un- 
asked testimony of one from the field. Is it not a satisfac- 
tion to know we have reasoned correctly ? Is is not a 
greater satisfaction to see medical men in authority endorse 
the same view ? Would it not be a still greater satisfaction 
to see the dread disease, tuberculosis, banished from our 
midst? It certainly would. It shall be seen, but perhaps 
not in our day. "The world do move." 

Turn back the page of history and walk with me in the 
streets of Ephesus. It seems but yesterday Diana, that 
ancient goddess, blindly ruled a queen, Around her stood 
the workmen and knelt the votaries at her shrine. Who 
dare blaspheme her name ? The workmen saw that in their 
craft was gain. They wildly cried, "Great is Diana, the 
Bphesian god!" What now remains of this once lordly 
queen ? Perchance a broken column proclaims the place 
she stood. 

The times have changed. We worship now around 



—57— 

another temple. It is a German mosque. The worship is 
as senseless as of old, the gain far greater, the maddening 
cry of workmen yet more deafening. Who now dare speak 
against this altar? Here and there a still small voice. 
That voice will yet be heard. 

Along the shores of time are wrecks of theories. Here 
a broken rudder, there a mast, tell plainly of a palace in the 
years gone by. It long has disappeared. So will it be 
with this. 



-58- 



THE GERM THEORY. 



'.'And he sat in the tent-door in the heat of the day." 
— Genesis 18:1 

The text needs little elucidation. The one spoken of 
is no less a personage than the patriarch Abraham. Of all 
worthy historic characters none stand more prominent. 

Born in Ur, of the Chaldees, about thirty-nine hundred 
years ago, Abraham, under a providence, not his own, be- 
came wealthy and the head of a numerous household. 

We read : ' 'The Lord had blessed Abraham in all 
things." 

It is not the purpose of the writer to dwell in detail, 
but his was a noble character, not perfect, but worthy of 
emulation. 

Two things are obvious : Abraham dwelt in a tent, 
and he rested at mid-day. 

The climate of Chaldea is such that life in the open air 
was common. Plainly, yet warmly clad, they dwelt as did 
their fathers, in tents and booths. Life to them was sweet 
in simple joys, which knew no after pain. 

Happy we, if in our race for greater joy had recognized 
the pain thereafter ! 

Man seeks greater closer habitations ; he builds a 
house. In building, had he kept the ventilation as in the 
tent or booth, all would be well. He builds regardless of 
an inner air, and garners as he sows — a spurious joy in dread 
disease — tuberculosis. In this we recognize a father's care 
is greater than man's protection. This, we think, is wisdom. 

Abraham rested at mid-day. Some think he idly sat, 
while others worked. The writer does not think so. He 
had been working, but at mid-day, while the heat was great, 
sat resting in the tent. A lazy man can never rest. Some 
may suppose he sat and slept ; the record does not say so. 
"And he lift his eyes and looked and lo," etc., showing 



—59— 
plainly he was wide awake — alive to duty. 

Multitudes are sitting, idly dreaming of the castles in 
the air, while the few are slowly moving upward, step by 
step, the golden stair. Of this few was plain old Abraham. 

Let us pursue the picture : 

"And lo, three men stood by him, and when he saw 
them he ran to meet them," etc. 

May we not learn a lesson ? Abraham sat, and looked 
and saw and acted. Let us imitate his example. 

Perhaps to day no one thing is receiving greater atten- 
tion from the medical profession than the germ theory of 
disease. Hundreds of Abrahams are sitting in their tents. 
Some, I verily believe, are resting. Many, wide awake, are 
looking with powerful miscropes and troubled gaze. Is the 
theory true or false ? 

What is seen ? In diseased conditions certain germs or 
microbes at the seat of lesion. At times, one kind alone ; 
at others, more than one. 

What is seen ? Myriads of bacteria or growing plants, 
subsisting on diseased or worn-out tissue in frail, unhealthy 
patients. 

What is seen ? A growing vegetation in a fertile soil. 
This is seen on every hand. Along the shores of lakes are 
seen the shoals of many fishes. At times, one kind alone ; 
at others, more than one. 

What is seen ? Myriads of the finny tribe subsisting on 
the food there placed, or propogating species of their kind 
in favored places. This is seen. Abraham could have seen 
the same and that without a microscope. 

As the fish along the shore take up the food and prop- 
ogate their kind, so bacteria in unhealthy tissue. 

Do bacteria cause disease ? Another class are looking, 
with microscope as fair and eyes as bright. They say, in 
words our own, no microbe, -per se can cause disease, unless 
said microbe be diseased itself. Wondrous knoweldge ! My 
friend, good bye. How can we yet determine the sickness 
or health of any microbe. 

Let us pass on. In passing would it not be wiser to as- 
sert that microbes are found in the environment most favor- 
able to growth ? The seed is scattered everywhere. It falls 



— 6o- 

in fertile places and takes root. Growing germs are found 
where there is proper food ; where proper food they propo- 
gate their kind. 

Do they cause disease? Look again. "Bacteria in their 
growth develop toxines." If by toxines is meant vegetable 
poison or alkaloid ; if by develop is meant store up in their 
substance, this statement is true. . 

"These toxines are given off by the growing vegetable 
organism." Abraham, where art thou? This, the writer 
thinks, is far from the truth. He finds no such fact record- 
ed in nature, giving plants do not give off their alkaloids 
while growing. They give them up only by infusion or ex- 
traction. Illustration : Strychnia, morphia, atropia, are 
vegetable alkaloids. Do the plants give off these poisons in 
growing? How utterly absurd ! This the writer endeav- 
ored to make plain some two years ago, vide "Status of the 
Bacillus." 

In order to be clearly understood, let us make a simple 
experiment. Put fifty pounds of rich earth in a box. Plant 
poppy seed in this earth. Place under the most favorable 
conditions of growth — light, heat, moisture, etc. The seeds 
germinate, the plants soon grow and develop to maturity. 
How do we obtain morphia ? Is there a physician in the 
land unable to answer? Listen to the bacteriologist : 
"Plants in growing develop toxines. These toxines are 
given off in growth." 

How do bacteriologists obtain morphia ? By collection 
from air, earth or water? If not, why not ? Do not plants 
in growing give off toxines? 

The following bacteriological experiment is very com- 
mon : Into a flask containing a small amount of bouillon, 
put a number of living tubercle bacilli. Let them multiply 
for several weeks. Filter out all the bacilli and inject a lit- 
tle of the filtrate beneath the skin of a guinea pig. See how 
quickly it succumbs. This, they say, is proof positive the 
plants give out toxines to the fluid in growing. The writer 
thinks not so. A plant in growing absorbs or inhibits the 
soil in which it grows. If the poppies in growing take up 



— 6i— 

one ounce of soil, there is just forty-nine pounds and fifteen 
ounces left. If in growing they develop one ounce of opium* 
this one ounce is found in the plants. No where else. As 
the plant in the earth, so the plant in the bouillon. 

Have we made this plain? If so, let us take another 
step. 

One suffers from tuberculosis. Tubercle bacilli are 
growing in his system; How are the symptoms of the dis- 
ease commonly explained ? Toxines are developed by the 
growing organism or bacilli. These toxines are thrown off 
by the bacilli in growing and continually poison the patient. 
Reason says the proper way to treat the disease is to give a 
remedy that will neutralize the toxines as thrown off by the 
vegetable organism. 

The writer smiles when he thinks of such foolishness. 
He at the same time feels vexed that men high in authority 
should make statements so erroneous. 

What is tuberculosis? A constitutional disease depen- 
dent largely on the evils of civilization and governed by the 
following law : The death-rate from tuberculosis is in direct 
ratio to suspension of atmospheric influence. 

In other words, tuberculosis exists before the entrance 
of the growing bacillus ; one has symptoms of the disease 
before there is evidence of the growing germ. 



— 62 



ARTIFICIAL IMMUNITY 



The world in many ways is growing wiser. A few 
centuries ago they little thought of the progress to be made 
in the arts and sciences ; of the methods of travel, war, 
commerce, etc., now in vogue. Could past generations rise 
and view the strides taken we think they would truly be 
illuminated. 

Medicine, like other things, has been moving. While 
here and there the movement is retrograde, the general 
trend has been ahead. Should those ancient gods or myths 
in medicine arise we think there are many things for them 
to learn. But hold ! Some boldly assert the dead already 
know more than the living. If true, they keep this knowl- 
edge to themselves. 

There is no reliable evidence to establish intercom- 
munication. We have little sympathy for thinking men 
who consult or worship dead medical heroes. The writer 
believes a "live dog is better than a dead lion." The light 
of these men went out in their death. It is seen only in 
their works — "Foot prints on the sands of time." 

In mathematics certain facts are so plain they need no 
demonstration. Illustration: The shortest distance between 
two points is on the straight line between them. 

Other facts equally plain are based on an assumption. 
Illustration: Two and two make four, i. e. 9 according to 
our system of notation. 

We assume one is one. If one be two, then two and 
two make eight. 

These two forms of truth we will designate as innate 
and assumptive. The two forms are found in medicine. 

There is this distinction. Innate truth is accurate 
under all conditions. Assumptive truth may be or may not 
be accurate in these same conditions. There is a wide dif- 



-6 3 - 

ference in the meaning. The one is truth, the other 
assumption. 

One who reasons and uses truth and assumption as 
synonyms may find fallacy in his conclusion. 

Have we made this plain ? We believe that 'he who 
claims a possible immunity from tuberculosis by the injec- 
tion of an alkaloid of the plant tubercle bacillus is laboring 
under the mistake named— taking an assumption for a 
truth. 

If the writer be correct, the reasoning is of necessity 
fallacious. If assumption and truth be used synonymously 
one has no moral right to ask acceptance of his teachings. 
Let us be honest. 

In discussion one is apt to be carried away by the heat 
of argument and utter things which he would not in his 
more sober moments. This is true in all controversy. The 
fire which generates steam if too strong may cause an ex- 
plosion. No explosion is desirable. Let honesty of pur- 
pose and fervency of spirit be the motto. The subject de- 
mands it. 

With one-seventh of the death rate caused by this 
dread disease, taken largely from a people in the prime of 
life and otherwise well fitted for years of usefulness, let no 
man stand by the death-bed of his fellow and trifle or de- 
ceive. Rather let us be honestly in earnest. 

"Tuberculosis is caused by the tubercle bacillus." 
What evidence have we of this ? 

(a) Tubercle bacilli are found in the disease tubercu- 
losis. A murder is committed in a certain village. A, B 
and one thousand others are found in this village. Is this 
proof positive that the one thousand and two committed 
the murder? Would any lawyer, judge or jury so regard 
it? Tubercle bacilli are found in health. Is their presence 
the cause of health ? 

(b) Tubercle bacilli are found growing in tuberculosis. 
Please examine this answer carefully. We desire it. 
Rushes are found growing in a certain pond. Do the 
rushes cause the pond ? Is not the pond a suitable place for 



-64— 

the rushes to grow ? In tuberculosis a diseased condition is 
present. The diseased condition is a suitable place for the 
tubercle bacilli to thrive. Being found growing in this dis- 
eased condition is no evidence these plants caused the con- 
dition named. How utterly absurd? That no one think 
the writer has gone daft on this subject, we herewith append 
the following letter: 

Colorado Springs, Col., October 8, 1898. 
Dr. H. H. Spiers: 

Dear Doctor: — I wish to say most positively that in 
what you say regarding the cause of tuberculosis, etc., "I 
am with you,'' and that it is only a question of time before 
the whole truth will be known , I have studied consump- 
tion now for sixteen years, both in laboratory research and 
in a general practice among consumptives, and I have mai^ 
facts to prove beyond question that the tubercle bacilli only 
attack a tissue prepared for it. Flies only "blow" a dead 
horse, as the cowboy says. 

Hoping to meet you some day, I am, 

Very sincerely, 

C. F. Gardner. 

With the above statement before us we trust no one will 
henceforth talk of tubercle bacilli creating a soil in a healthy 
subject. They do no such thing. In every case of tuber- 
culosis the soil is prepared before the bacilli take root and 
grow — prepared in one way — suspension of atmospheric 
influence. Hence the law of tuberculosis : The death rate 
from tuberculosis is in direct ratio to suspension of atmos- 
pheric influence. This law the writer has advocated for the 
past twelve years. If true, the disease tuberculosis can be 
controlled. 

(c) Tubercle bacilli or their pure cultures are injected 
into healthy guinea pigs. In every case these animals die 
of tuberculosis. This, says the germ theorist, is proof pos- 
itive the tubercle bacilli cause the disease. Let us examine^ 
Admitting the injection causes the result named, it is nec- 
essary to show (1) the human race is a race of guinea pigs' 



-6 5 - 

(2) the method of injection is nature's method. Neither 
can be shown. 

(d) Tuberculosis is infectious. Example: Mr. H.^ 
aged twenty-five, is in poor health. He marries a healthy 
girl. Two or three years later the husband is told by an M. 
D. that he has tuberculosis. Mr. H. takes but little medicine, 
confines himself almost wholly to the house, and the wife, 
who is very much attached to him, stays long in the same 
room and ministers to his wants. One year from his first 
illness he dies of tuberculosis. His wife dies of the same 
disease about six months later. The neighbors say, "She 
caught the disease from her husband." 

If one take the disease from another in what way is the 
infection conveyed? In other words, if tuberculosis be due 
to suspension of atmospheric influence, how can this sus- 
pension be conveyed to another person? Do not be too 
hasty in judgment. Let us hear a further recital. 

Mr. B., of P., aged twenty- three, marries Miss T., of 
K. His family history is decidedly bad. At the present 
writing all the family — parents, children and grand-children, 
nine in number — are dead. The family tree is extinct. 
With but one exception all die of tuberculosis. One child, 
I think an infant, died of diphtheria. 

Mrs. B., his wife, aged twei^-one, is healthy, but 
never robust. About two years after their marriage Mr. B. 
dies of tuberculosis. His wife is very attentive in his sick- 
ness and does everything possible for him in her power. 
Eighteen years have elapsed. Mrs. B. looks older, but is in 
as good health today as in those days of her marriage. 
Will any M. D. in the land assign a reason why Mrs. B. did 
not take the disease ? Do not be too hasty and we will 
recite another case. 

Mr. B., of E., aged twenty-two, of poor family history, 
imperfectly recovers from typhoid fever. Two }< r ears later 
he marries Miss H., of about the same age and of fair fam- 
ily history. They settle in the township of R., and build a 
new house. Two children are born of this union, the elder 
still living, though delicate; the younger, an infant of six 



-66— 

months, dies of tuberculosis. The father dies of the same 
disease about six weeks later. Mrs. B. cares for both hus- 
band and child during their illness. Eight years have 
elapsed. A month or two ago I met this lady on the streets 
of this village, the picture of health. Why did the second 
Mrs. B. escape this disease? 

In both cases, narrated from life, the reason is simple. 
Need I explain ? It is these little things which tell me the 
law of tuberculosis must be true. It cannot be otherwise. 
How did they escape ? By having perfect ventilation in the 
rooms occupied. There is no danger whatever of "catching' ' 
or contracting tuberculosis if the ventilation be perfect. 
Why ? Because the tubercle bacilli cannot create a soil in 
the healthy individual. The soil is created by suspension of 
atmospheric influence. Write this in your note book, I 
solemnly declare it is truth. How, then, does a wife or 
husband "take" the disease from a partner? By living in 
the same environment, which is an improper one. This 
truth was shown many years ago. We have referred to it 
before. We refer to it again : 

"From the statistics of the Brompton hospital, collected 
by Drs. Cotton and Edwards, it has been shown that of the 
many nurses and others engaged in that institution during 
twenty-one years, but one nurse and one servant died of 
phthisis. Especial care seems to have been taken in the 
Brompton hospital in regard to ventilation and other 
hygienic conditions. Dr. Cotton's expression is that 'a 
residence in the consumptive hospital and long-continued 
working in its wards is a very good way, indeed, not to 
catch the disease." (Reynold's System of Medicine, vol. 
II, p. 117, revised by Hartshorne.) 

It is seen that especial care is taken in this hospital in 
regard to ventilation, etc. What other hospital has taken 
like care ? What other hospital has a like record ? It is 
not that we know less than formerly, but is it not true we 
have gone daft after a germ theory ; Is it not true our 
present system of medicine is so Germ-amzed that we think 



-6 7 ~ 

of little else except germs ? 

It is therefore seen if a, b, c and d are trie valid reasons 
why tubercle bacilli causes tuberculosis, the statement that 
they do cause said disease is assumption. If assumption 
be used as a synonym of truth, the conclusion is fallacious. 

To return, if tubercle bacilli do not cause tuberculosis, 
how can we rationally say their alkaloid affords immunity ? 



68 



THE BICYCLE A PREVENTIVE. 



The world moves on wheels. How rapid the pace. 

"Art is long and time is fleeting." 

As we look from our window and see the many swiftly 
gliding by on wheels, the question arises, how will the race 
be fitted for the "struggle for existence" in the years to 
come. 

On the good to result from the use of the bicycle, as of 
other things, there is a diversity of opinion. Whether the 
bicycle prove a benefit or a curse will largely depend on its 
proper or improper use. Some, predict a future race of 
humpbacks, with deflected spinal columns, etc. 

The writer takes a more hopeful view. He thinks as 
time passes the wheel will be made more specially adapted 
to individual wants. Each person cannot wear the same 
clothes. Why should wheels be made so nearly alike? 
The tall and the stout, the lean and the obese should each 
have a wheel adapted to his needs. The novelty in use .will 
wear away. Each will learn while there is celerity in move- 
ment and time saving in use, there is also a limit to physi- 
cal endurance. 

In the future we will be more conservative of our pow- 
ers. Grace in riding will be sought in the future. We 
cannot all be handsome. It should be the aim to ever ap- 
pear at our best. So that taking all in all, we are inclined 
to think many of the evils now existing in the use of the 
wheel will pass away. 

Beauty in the wheel will give way to grace in riding. 
Rapidity in motion to comfort in using. Novelty to utility 
and the world will be made better by its introduction. 

There is a phase in its use on which we wish to dwell. 
The wheel leads to out-door exercise. 

The toiling millions have exercise enough, say some. 



-69— 

Where is this exercise ? In the dusty shop or ill-ventilated 
hall. Mechanics, merchants, orators, laborers, all breathe 
an atmosphere absolutely impure. In this great world of 
ours, with the vast oceans to purify the air, should we 
breathe such vile stuff ? No ! A thousand times no ! 

What are we doing in breathing impure air ? The 
lodgment of dust in the air cells of the lungs causes sus- 
pension of atmospheric influence from without. 

The inhaling of impure or impoverished air causes 
suspension of atmospheric influence from within. What 
does suspension of atmospheric influence induce? The 
precedent state or condition ; tuberculosis in its incipient 
state. 

What does exercise in the open air accomplish ? The 
inflation of the air cells of the lungs and the inhalation of 
volumes of pure air. 7 he -prevention of the precedent 
state or tuberculosis 

Who most readily take tuberculosis ? 

They who have the greatest suspension of atmospheric 
influence. 

Who most readily convey tuberculosis ? 

The mothers of our land. Mothers, let us have more 
wheels. They prevent tuberculosis, the greatest evil of 
civilization and the greatest foe to the human race. 



7o- 



LEGISLATION. 



A legislator should be argus-eyed. All feel the burden 
of taxation, have ideas of just and unjust law, and recog- 
nize the worth of public officials. Taxation should be equal, 
laws just and officials honest. This the legislator should 
know. He finds it difficult to place the burden of taxation 
equally, to know at all times a just from an unjust law, to 
be strictly honest on every occasion. The law giver may 
strive to do his duty, fulfill all the necessary conditions, yet 
be misunderstood or misrepresented by many rivals and fail 
at the next election. 

These are a few of the trials or tribulations which every 
law giver meets. Truly, the legislator should be argus-eyed. 
He should have great wisdom. Legislation is asked on a 
subject of which little is known. This is an unjust de- 
mand. Education should precede legislation. The legisla- 
tor has the right to ask enlightenment. A subject is clearly 
understood, yet there is a diversity of interest or opinion. 
One party asking, another denying, legislation. Here great 
wisdom or its opposite may be shown. 

It is a function of the legislator to exercise tact and 
judgment. In the exercise of these success or failure is as- 
sured. Barring those cases of exceptional wisdom and tact 
in the legislator, legislation can advance no faster than the 
public sentiment which lies behind. In a republic we have 
no moral right to ignore our laws. It is we, the people, 
who make them. The legislator is only our instrument. 
He should be wise. 

We have spoken of honesty. Without this all other 
traits or characteristics will fail. No matter how wise, per- 
suasive or brilliant, if honesty be lacking, no worthy legis- 
lation can be assured. It may be said if one be wise, he will 
also be honest. Not necessarily so. There is a wordly wis- 



—7i— 

dom without honesty; a love of office or power with evil 
intention. "A devil's purpose with an angel's face." 

If, then, we have correctly reasoned, three things are 
essential in the legislator, viz, many eyes, wisdom and hon- 
esty. 

Having spoken of the essentials in a legislator, having 
referred to the difficulty of always securing proper legisla- 
tion, and the necessity of education preceding it, we now 
take up a subject on which a great deal has been said, little 
formulated, and less put into execution. We refer to legis- 
lation on tuberculosis. 

It is the concensus of medical belief that tuberculosis 
can be controlled. The medical world is shouting this on 
every hand. L,et the legislator ask the question, in what 
way can tuberculosis be controlled? Many are silent, more 
are indefinite, and a few continue to talk without ideas. 
Some physicians have this latter faculty in an intense de- 
gree. It is not a faculty to be sought in prayer. Our prayer 
should rather be, not more words, but ideas. 

It is evident the method of ridding ourselves of this 
deadly disease will depend largely on its cause. If we have 
a large vested interest in bacteria, having traveled and stud- 
ied extensively at great cost, no doubt it will measurably 
shock our sensibility and pride to be told that bacteria are 
of little worth in tuberculosis, and may be ignored entirely 
in the control of this disease. If the truth is to be spoken, 
let not a vested interest swerve us to the right or left. Leg- 
islators should be wholly disinterested. 

Again, if we hold a chair in some school of medicine, let 
not the emolument of office or the pride of power prevent the 
discernment of right and wrong. Let our motto ever be, 
learn to unlearn that which has been learned amiss. Knowl- 
edge sought and won in this wa5^ is power. To the thinker, 
no other knowledge is worthy a place. 

If rightly understood, we now have a w 7 ise, honest and 
disinterested legislator. He asks: "What is tuberculosis?" 
We answer, a constitutional disease dependent largely on 
the evils of civilization, and governed by the following law: 



-72— 

The death rate from tuberculosis is in direct ratio to sus- 
pension of atmospheric influence, Please observe, in this 
answer no reference is made to the tubercle bacillus what- 
ever. 

According to the writer, then, the wise, honest and dis- 
interested legislator will take no cognizance of the tubercle 
bacillus in framing a law for the prevention of tuberculosis. 
All laws framed will be against the evils of civilization; 
none against the tubercle bacillus. 

Says one: "Do we understand there will be no legal 
notice taken of promiscuous spitting ?" None, whatever. 
This, we think, is a proper subject for education, not legisla- 
tion. People should be educated to be cleanly in their per- 
son, habits and environment. We think one could no more 
be legislated into cleanliness than into righteousness. Kach 
is -a subject for education. 

But says another: "Is it not true that tubercle bacilli 
are continually floating in the atmosphere ? Must we not 
prevent this?" Says the writer, it is true that tubercle ba- 
cilli are found in every atmosphere, more prevalent in some 
than in others. Two questions present: (i) Can we pre- 
vent their presence ? (2) Would prevention be of value? 
On the answers given these questions must hinge all law 
against the germ. 

In regard to the first, every medical man will agree that 
it is absolutely impossible to destroy all microbes or bacteria 
in the atmosphere. Why attempt the impossible ? Suppose 
we could destroy all bacteria in the atmosphere, what would 
it avail ? Bacteria are present in the food we eat and the 
w r ater we drink. Suppose we could destroy all these ? If it 
be shown the tubercle bacilli do not cause tuberculosis, of 
what avail the destruction ? The wide-spread disease tub- 
erculosis would still be prevalent. With the premises 
before us, no other conclusion could be reached. 

The reasoning of the germ theorist is somewhat as fol- 
lows: Tuberculosis is caused by the plant tubercle bacillus. 
The more plentiful the germ in the atmosphere, food or 
drink, the more prevalent the disease, and vice versa. 



—73— 

Could we in any way diminish the number of tubercle 
bacilli, we could diminish the prevalence of tuberculosis in 
the same ratio. Germicides, control of sputa, etc., dimin- 
ish the number of tubercle bacilli per cubic foot of air space. 
Therefore, germicides should be used and the sputa con- 
trolled. These, therefore, are proper subjects for legislation. 

This reasoning seems plausible, yet it is fallacious. 
Let us examine. In the first place, the prevalence of tub- 
erculosis is not in proportion to the number of tubercle 
bacilli in the atmosphere. Some will say at once that this 
is not true. It is true. 

We have already referred to the observation of Drs. 
Cotton and Edwards in the Brompton Hospital for Con- 
sumptives. Conditions in hospital, ventilation and hygiene 
good. Number of years in observation, twenty-one. 
Number of attendants who died of the disease, one nurse 
and one servant. Conclusion: "A residence in the con- 
sumptive hospital and long-continued working in its ward 
is a very good way, indeed, not to catch the disease. 

Take the same conditions except ventilation. Think 
you no attendants would have died ? All attendants would 
have died of the disease. Why? Because imperfect venti- 
lation is suspension of atmospheric influence, or a condition 
in which the living tubercle bacilli enter the system and 
grow. 

In the two cases wherein is the difference? Opening 
or closing a window or door does not alone determine the 
absence or presence of tubercle bacilli in the atmosphere. 
How foolish ! There must be something else. What is this 
something else? It is the -perfect ventilation that renders 
the system immune. Here is the immunity long sought, 
not an injection. It is the imperfect ventilation that ren- 
ders the system a fertile soil. Hence the law of tuberculosis. 

The corrected proposition, then, reads: "The preva- 
lence of tuberculosis depends on ventilation, not the number 
of bacilli." This is an important consideration, one which 
the biologist would do well to stop and investigate. We 
hardly look for this at present, he is so thoroughly imbued 



-74— 

with a germ theory. 

In the second place, tuberculosis is not caused by the 
plant tubercle bacillus. We have spoken of this in other 
places. We endeavor to be brief at this time. 

It is evident to any thinking mind that a plant cannot 
precede the soil in which it grows. Please consider: The 
tubercle bacillus is a plant, the soil is the being in which it 
grows. The being in health does not have growing bacilli. 
Why not? There is no soil. So soon as suspension of 
atmospheric influence takes place in said being so soon a soil 
is present and so soon the tubercle bacilli take root and 
grow. Is this plain ? When the ventilation is perfect there 
is no soil, and consequently no growing bacilli. This is 
true, no matter how few or many tubercle bacilli are in the 
atmosphere. If, then, the ventilation be perfect, there is 
no danger whatever of catching the disease tuberculosis. 
In this condition the tubercle bacilli are perfectly harmless. 

We are writing to rational beings. How, then, ought 
we to proceed ? Attempt to destroy the harmless tubercle 
bacilli, or render the ventilation perfect ? Which view 
ought to engage the attention of the wise, honest and dis- 
interested legislator ? There can be but one answer, legis- 
lation should be for better ventilation, l^eave the tubercle 
bacillus alone; it needs no care. 

In the course of events, as tuberculosis becomes less 
prevalent, through a purer atmosphere, the tubercle bacilli 
likewise become less. Whether few or many, it matters 
little if the ventilation be correct. 

What, then, shall we say of germicides and the control 
of sputa ? Germicides are of little worth. It is not neces- 
sary to use them. Tuberculosis can be controlled in a bet- 
ter way. Every one should care for his sputa, but the care 
of it is not a proper subject for legislation. "Cleanliness is 
akin to Godliness." Cleanliness should be taught. 

If the writer' s conclusions be correct the reasoning of 
the germ theorist must be fallacious. What, then, is a 
proper subject for legislation ? Ventilation. 

In order to present this subject in a clear light perhaps 



—75— 

one or two illustrations would be proper. In referring to 
these it is not to condemn any particular system, but simply 
to illustrate. The cases chosen are the ones which come 
most readily to mind. 

In the elevated railroad of New York a method of 
rapid transit is in vogue that is unsurpassed in this country. 
The trolley or horse car of other cities is excellent. All 
these systems have one fault, viz., the ventilation of the 
crowded car is poor. The writer has been on the New 
York road when every inch of available space was occupied ; 
no room to stand. The same may be said of the horse car 
line on Broadway as it was a few years ago. This condi- 
tion of things ought not to be. The situation seen in New 
York is seen in many other large cities. Every seat in a 
car should have a proper air space for its occupant. Every 
occupant should be given a seat. Then the question of 
ventilation is settled at once and forever. The ventilation 
of the car should also be perfect. In short stops and fre- 
quent changes this would be materially aided by frequent 
opening and closing of the doors. In long runs the case is 
different. Here the most perfect ventilation should be 
secured. One source of annoyance in long distances in the 
irritant dust. How to eliminate this and at the same time 
secure perfect ventilation is a question for science. Its 
present aim seems to be how best to catch, destroy or elim- 
inate the bacillus. The writer thinks its field of action 
should be changed. 

But ill-ventilation is not seen in the car alone. It is 
seen in the hall, church or shop; in truth, wherever people 
congregate. It is also seen at the fireside in the home. 
When will we learn wisdom? "Wisdom is the principal 
thing; therefore get wisdom." 

It may be said the question of legislation, in regard to 
ventilation, is a complex one. It is complex, yet it is very 
simple. Pure air is abundant. It is also free. Why 
should there be difficulty in obtaining it ? The first ques- 
tion to consider is one of desire. Do we, as a people, desire 
pure air ? If it be best for us to have it, if it be abundant 



- 7 6- 

and free, why should we hesitate ? It seems to the writer 
it is a question of education alone. 

There are many things we earnestly desire. They 
cannot be obtained, or if received they spoil us or injure our 
health. When a necessary is to be had at so little cost we 
should reach out our hands and receive or demand it as our 
right. This is American. 

We are taking a journey. The car or boat or bus is 
crowded. One passenger desires pure air; the rest are 
satisfied as it is. The conductor or captain or cabman is 
asked to open a window or door. Many at once object for 
fear of taking a cold, and the window or door is closed. 
All suffer from the closure. Do we not need education ? 
A consumptive or one having a cough enters this crowded 
car or boat or bus. He coughs or expectorates from neces- 
sity. The one in authority says: "My dear sir, or madam, 
you must not spit in this car." "Why not? Havel not 
purchased a ticket?" "Your ticket is all right, but you 
must not cough and expectorate while on this car." "My 
dear conductor, why do you not give us pure air?" "You 
talk to the authorities about that." The authorities are 
investigated. "We are perfectly willing to conform to any 
reasonable public demand. Scientists tell us there is great 
danger from dried sputa. It becomes disseminated through 
the air and causes consumption, etc. Scientists are silent 
as to ventilation." 

Do we not need education ? We certainly must edu- 
cate before we can legislate. Legislation without public 
sentiment behind it is a dead letter. Education and legis- 
lation, like twin sisters, walk hand in hand. 

What, then, shall a traveling public demand of its car- 
riers ? Perfect ventilation, abundant air space and a seat 
for all. 

How shall we render our halls, churches, schools, etc., 
less dangerous ? By having them more perfectly ventilated. 
This can be accomplished in many ways: (a) I^ess seating 
capacity or larger air space; (b) better heating apparatus, 
in that less atmosphere of the room is impoverished, i. e. } 



—77— 

by having greater heating surface and less intensity of heat 
less oxygen is abstracted from the air in the room; (c) an 
abundant supply of pure air partially warmed before enter- 
ing the room; (d) an exit for all vitiated or impure air. 
These taken collectively, with a proper construction of the 
building or room, will fulfill all needs. 

Many churches or halls are erected as to external ap- 
pearance or acoustic properties. While these must not be 
lost sight of, the ventilation of the building is of far greater 
importance. The life of the audience is of more value than 
the beauty of structure or voice of speaker. Architects, in 
making designs, should think of this. 

What shall we say of the home ? Our home is where 
we live or abide. Where is the home? In the country or 
city? Is it our own or another's? Or, rather, do we hold 
or rent ? The answer to these must modify the answer 
given. If in the country there, is greater opportunity to 
breathe pure air. The same may be said if the home be our 
own. In rented flats or rooms in the city we receive that 
for which we pay. If able to pay we receive the best; if 
unable to pay we must take that which we can get. With 
the poor wage earners it is often take the poorest or none at 
all. How comfortless are these ! How illy ventilated ! 
Often, how short lived the occupants ! Cannot legal re- 
straint give them better homes ? 

We have often thought in visiting country homes, what 
a field for cultivation ! How lovely and pleasant some of 
these homes are ! What taste and munificence ! Yet oft- 
times it is outward adornment like dressing the hair or 
body, not that inner fitness so essential to worth or useful- 
ness. Seldom does the architect or builder think of that 
inner adornment — ventilation. What a pity ! In other 
homes, how destitute and comfortless ! The home is a 
mere hovel or shelter. 

It is not the elegant home that confers health and 
longevity. Frequently it is the poorest. One log cabin the 
writer recalls, which contained a large family. It was so 
open the stars could be seen through the wall on either side. 



- 7 8- 

Yet that family lived in that home many years. Little sick- 
ness, plenty to eat and do made that home a happy one. 
The family grew to manhood and womanhood, separated 
and organized homes of their home. How beautiful the 
picture ! This is not seen in every home. 



—79" 



CONTROL. 



Of all historic diseases which have afflicted mankind, 
no continuous disease has been less subject to control than 
tuberculosis. There have been epidemics or endemics 
that were more fatal or less subject to control for short per- 
iods of time. But these have been only for short periods. 
These diseases die out for want of fresh fuel, or their very 
contagiousness has demanded great effort, which has re- 
sulted practically in control. 

With tuberculosis the case is different. This is a dis- 
ease with which we all are practically familiar — one which 
every medical man thinks he understands. The very clear- 
ness of apprehension with which he thinks he sees leads 
him blindly on in treatment or prevention. Hence no stop 
or cure. 

It is a common impression that tuberculosis is due to a 
germ. If true, the germ being killed the disease would at 
once cease. Methods of destroying germs are familiar to 
all. It is plain to the ordinary observer they are of little 
value. Germicides -per se being valueless, it enters the 
minds of some that perhaps a condition of the system may 
be induced that will prevent the entrance of germs, or — 
may be better — will not allow their growth. Germ cul- 
tures are procured and their alkaloids used to fortify the 
system or render it immune. With a pains- taking accuracy 
worthy a better result, these germs are isolated, cultivated 
and the alkaloids injected for this purpose. 

The result is before us. Is tuberculosis lessened by 
injections of these cultures? There are many occupying 
chairs in medical colleges who would be pleased to answer 
in the affirmative, but facts do not bear out the assertion. 
Instead of boldly saying no, which would be the writer's 
course, the attempt is made to waive a direct answer to the 



-8o— 

question and encourage a hopeful view for the future. 
At the same time these teachers are continually instructing 
in methods which have long since proved practically nil. 
Is such instruction a benefit ? Finding it impossible to kill 
the germs in the air or in the person without injury, rinding 
immunity largely an imaginary quantit} 7- , men have in some 
quarters advocated germ-proof houses. It is soon seen by 
all except a few fanciful scientists that even these germ- 
proof buildings could be of little value. 

The question now arises: If present notions prevail, how 
soon will tuberculosis be under control ? No one can clearly 
answer,' for no one knows. Under the circumstances, would 
it not be wisdom carefully to investigate the cause of dis- 
ease and see if there be not some other connecting or under- 
lying condition which allows the living tubercle bacillus to 
enter one's system and grow? If such condition be found, 
would it not be further wisdom to inquire if this condition 
is always present in the growth of tubercle bacilli in the 
human organism ? If always present, would it not yet be 
further wisdom to ascertain if this condition cannot be re- 
moved, and thereby prevent the entrance of a growing 
bacillus in one's system ? If this condition exists, is always 
present, is removable, we hold in our hands an effectual 
weapon for the prevention of tuberculosis. 

The writer claims that here is a succession of facts the 
force of which cannot be weakened by any argument. In 
other words, here lies a chain of reasoning on which the 
law of tuberculosis is based. This law is based on facts as 
immutable as is any law of Kepler or Newton. This law 
must stand. What is the law of tuberculosis ? The death 
rate from tuberculosis is in direct ratio to suspension of 
atmospheric influence. 

Having laid down a law of tuberculosis, let us now 
critically examine the facts on which this law is based. 
My attention was called to these many years ago. The 
first published article bearing on the subject is found in the 
December number of the Cleveland Medical Gazette, 1890. 
Phthisis pulmonalis is here spoken of as a zymotic disease. 



Medical experts had so placed it, and this opinion was ac- 
cepted without question. Upon investigation the contag- 
iousness of the disease was in doubt. It was found there 
are certain conditions of the system in which one apparently 
takes the disease. There are other certain conditions in 
which one does not take the disease. The question arose: 
On what does the contagiousness or non-contagiousness of 
tuberculosis depend? In answer to this, it is seen that cer- 
tain animals are affected and the same animals are not 
affected, according to the condition in which they are 
housed or kept. Some in authority have lately asserted 
that food or diet has as much to do in the origination or 
starting of tuberculosis as has the atmosphere. The writer 
thinks that in this statement there is a misconception. It 
is not the atmosphere -per se, but suspension of atmospheric 
influence that induces the condition or disease. Food or 
diet, according to quantity and quality, may improve or 
weaken the physical or mental condition. This, I think, is 
about all. Suspension of atmospheric influence, whether 
the animal be weak or strong, will produce a condition of 
the system which allows the tubercle bacilli to enter and 
grow. 

While suspension produces a condition favorable to the 
growth of a germ, food produces simply a strong or weak 
condition of the system and has no relation to the germ's 
growth whatever. This, I think, is a marked difference, 
and one which even late observers have entirely overlooked. 
Again, it is evident that if the basic facts be changed, the 
law depending on those facts must be worded differently. 
This accounts largely for the change made in the law. 

Another fact may be referred to at this time. It is 
very difficult for some to enter into a discussion or investi- 
gation in which figures or mathematics are used. In order 
to accommodate this class, the law is stated in the simplest 
language possible. The writer feels assured that those who 
impartially investigate the subject will find the conclusions 
accurate. 

With this simple law before us as demonstrated, with 



-82 — 

the deadly disease before us as seen, it is the writer's hope 
and belief that much may be accomplished in a practical 
way by simply living in accord with the teachings of this 
law; by avoiding in every possible way the suspension of 
atmospheric influence. A deadly enemy is before us. In 
every engagement thus far we have met defeat. Let us 
train our guns to do the most effective work. Before enter- 
ing an engagement it is always well to take an account of 
the character of weapons to be used. One great difficulty 
in the recent past has been that the bacteriologists have 
taken upon themselves the entire work. This I think is a 
mistake. Bacteriology is one arm of the medical service. 
Its work along its own line is of great value; its work in 
other lines of no value whatever. 

To illustrate: We have many ships in our navy — bat- 
tleships, cruisers, torpedo boats, etc. Suppose a captain of 
a torpedo boat should say, "My boat will act as a battle- 
ship." Or the captain of a battleship should say, "My 
boat will act as a cruiser." Or the captain of a cruiser 
should say, "My boat will do the entire work; the rest of 
you may remain idle." What would be the condition of 
the navy ? Any one could see that the service would be of 
no practical benefit whatever. We might as well do with- 
out a navy as to have one boat arrogate the entire service 
to itself . Thus with bacteriology. Bacteriology has been 
pushed forward to the exclusion of everything else. I 
trust some of my contemporaries will see the force of this 
assertion. 

There is another insuperable difficulty which bacter- 
iology has met in the battle with tuberculosis. It is as- 
sumed that tuberculosis is a germ disease. If it were a 
germ disease, rationally considered, it could be met with 
germicides or the alkaloids of germs. It not being a germ 
disease, rationally considered, germicides or alkaloids of 
germs would be of no value. Whether the disease be due 
to a germ or not, I leave to an intelligent profession; this 
much is certain, bacteriology has thus far found no cure for 
the disease. The same may be said of other methods of 



-8 3 - 

treatment. The writer believes that the secret lies in 
recognizing the cause of tuberculosis. It is plainly evident 
if the cause of tuberculosis be suspension of atmospheric 
influence, no line of treatment could cure without first 
recognizing the cause and removing it. Even then, if 
there be destruction of tissue, no treatment could restore 
tissue lost. These facts must be taken into consideration 
when talking of cure. So that he who asserts he has a cure 
for tuberculosis either falsifies or is ignorant. 

There being no cure for tuberculosis, it remains to be 
asked : In what way can we arrange our forces most effect- 
ually to battle with the disease ? To the writer it seems 
clearly evident that the control of the disease must be large- 
ly along the line of prevention. Now do not misapprehend. 
The writer believes that open air and constitutional treat- 
ment are of great value. In truth, in conjunction, they are 
the best treatment of tuberculosis known to the science of 
man. At the same time, to repeat a well-worn aphorism : 
"An ounce of prevention is worth a pound of cure." There 
is no cure for tuberculosis. There is prevention. If pre- 
vention succeeds, there is no need of cure. Today this hy- 
dra-headed disease exists on every hand. There is need of 
prevention and there is also need of treatment. Insiduous 
and deadly in its nature, say not to the afflicted that there 
is no value in treatment. There is value in treatment. But 
if cure be perfected, treatment must be given in the prece- 
dent state or incipient stage of the disease. Then there is 
cure. But, as said in a previous article, if there be disorgan- 
ization or breaking down of lung tissue, this tissue can never 
be restored. Yet even in this condition treatment is of value 
and by its judicious employment life may be prolonged, 
and aid and comfort given the afflicted. This elone is cer- 
tainly worthy our consideration. 

To speak directly of prevention, the first step to be 
taken is to remove the cause of the disease. If the disease 
be due to suspension of atmospheric influence alone, the 
first step in prevention is to remove the suspension. With- 
out this, nothing can be accomplished. With this, much 



-8 4 - 

can be accomplished. If due to heredity in conjunction 
with suspension, here the battle must continue as long as 
life lasts. Heredity is an entity of the parents, and must 
be controlled in the rising generation by proper marriage. 
Let no one marry into a consumptive family, should he de- 
sire healthy offspring. Evidently the marriage relation is 
a serious one if we look at it in the light of transmission of 
disease. Every one who asks in marriage should have a 
clear health register and he should expect the same of his 
partner. Without this, tuberculosis will remain a disease 
in the human family to the end of time. With this, tuber- 
culosis can be controlled. 

In a recent session of our legislature some one intro- 
duced a bill to regulate marriage. What became of the bill 
the writer only conjectures. One thing is known — the way 
in which the measure was received. Some spoke of it as 
ahead of the times; others as visionary, unnecessary, ridic- 
ulous, etc. It is not worth while to discuss the merit of 
this particular bill. This much is certain: In the years to 
come some measure of this character will be enacted to pre- 
vent disease. Education must ever precede legislation. It 
is education today, legislation tomorrow. In this way, step 
by step, the human family has risen in civilization. The 
laws of Ohio today could not be enforced in present China. 
The laws of Ohio, it is hoped, will be changed for the better 
in the years to come. True, it is difficult to legislate on 
marriage. To say one must or must not is somewhat arbi- 
trary. Is it not best to do so ? When one is educated to 
select only the best in marriage, it is more largely a matter 
of choice or judgment and less one of impulse or emotion. 
Not long since a man of this city, pointing to a deformed 
child, said: "If nature could give me no better body than 
has that child I would ask to be shot/' Please reflect ! 
What was nature's act other than the volition of the par- 
ents ? Why not legislate ? 

Reverting to suspension of atmospheric influence, this 
may be induced in many ways. The following classifica- 
tion presents the subject in the clearest light possible. 



SUSPENSION OF ATMOSrHKRIC INFLUENCE. 

atmosphere { D1 ventilation > vocation,etc. 
From without 1 T ., , j Over-heating rooms, im- 

I atoolphere { Proper ventilation, etc. 



From within 



(Defective f 0ri S inal {Heredity. 

Di< 

ure, etc. 



) jjerecnve J ( 

| lung tissue | Acquired> (Disease, expos 



To explain more fully, suspension takes place in two 
ways — from within and from without. 

From within through original or acquired lung tissue. 
Though the scalpel or microscope may detect no difference 
in lung tissue, it is observed that children of consumptives 
take the disease more readily than children of the healthy. 
Why? Defective lung tissue — heredity. Such children 
will tolerate no confinement. Confinement to them means 
death from tuberculosis. These children die from the dis- 
ease, while other children escape — ventilation, food, phys- 
ical exercise, etc., being the same ; thus showing that there 
is a difference in the organism or lung tissue. It is also ob- 
served that those having stenosis of the air passages whether 
congenital or acquired, are more subject to tuberculosis t 
Why ? Suspension of atmospheric influe nee. In some of 
these cases operation to remove the stenosis is beneficial. 
In all, there should be perfect ventilation. 

There are certain diseases which tuberculosis is pretty 
sure to follow if precaution be not taken, viz., measles, 
pertussis, etc. Why? Defective lung tissue— acquired. 
Suspension of atmospheric influence due to thickened lung 
tissue. What precautions are necessary ? Perfect ventila- 
tion during sickness and recovery. 

From without, through impure or impoverished atmos- 
phere. Every observer has noticed that there are two classes 
in particular who suffer much from tuberculosis — they 
whose vocation or calling keeps them continuously in the 
dust and they who suffer from confinement in ill- ventilated 
rooms. In the first class there is suspension from lodgment 



-86— 

of dust particles in the air cells of the lungs or from me- 
chanical irritation of the same — one or both, commonly 
both. What is the preventive ? Avoidance of the irritat- 
ing dust, (i) Change of vocation; (2) wearing of adust 
protector; (3) elimination of dust by a dust collector. 

If heredity be a factor, the first method should be 
adopted. No one should engage in or follow an unfavora- 
ble pursuit if the subject of hereditary influence. Though 
the usual precautions were taken, the probability is he 
would die of tuberculosis. If the subject be vigorous and 
have a good family history, he may follow the vocation of 
his choice. In this case a dust protector is of service, but 
unequal to a dust collector. In all shops where there is an 
irritating dust these collectors should be obligatory. 

We now reach the topic of impure or impoverished 
atmosphere. This has been explained elsewhere, but a 
word or two in this connection will not perhaps be out of 
place. We, as Americans, are living in homes many of 
which are warmed by furnace heat. In all homes there is 
artificial heat for a part of the year. In these homes the 
atmosphere is at times impoverished. As a result the occu- 
pants suffer largely from respiratory and constitutional dis- 
ease , Tuberculosis is of this number. It is prevalent and 
deadly. Treatment is of little avail. Prevention is of 
value. The preventive, the writer is inclined to believe, 
consists in a stove or furnace of at least double the size or 
capacity of the one ordinarily used. It takes no more fuel, 
the heat is more constant and even, and the stove or fur- 
nace lasts longer. There is, therefore, no greater expense 
in the end. There is an assurance of better health. The 
danger in cold weather is that too much oxygen is with- 
drawn from the room to support combustion, and not enough 
air is let in to replace the oxygen abstracted. Suspension 
of atmospheric influence is induced. In this way plants 
and animals alike suffer. 

There is another factor which should engage our atten- 
tion. I refer to the irritant dust of soft coal stoves and 
furnaces. In the present arrangement of these, nearly all 



-8 7 - 

give off an irritant dust, smoke or vapor. Irritation of the 
throat, fauces and bronchial tubes commences soon after 
their use. This should not be. The draught should be 
perfect, so as to allow no dust in the room. If it is not 
perfect, there is suspension of atmospheric influence because 
of the irritant dust; also because of the lack of oxygen in 
the air. Consequent tuberculosis. When these facts are 
clearly understood and acted upon, the writer feels satisfied 
the death rate from tuberculosis will be much diminished. 
If true, this statement is worthy of consideration. In the 
above I refer to the atmosphere as found in country homes 
and villages. In large cities, as a rule, it is very much 
more impure. Large cities are railroad centers, contain the 
factories, workshops, etc. There are, of necessity, great 
volumes of smoke. At times the outdoor air is almost un- 
endurable. Science can and no doubt soon will remove this 
smoke nuisance of cities. 

There are other factors, not mentioned, in cities which 
contaminate the air and render it unfit to breathe. I pass 
over these. One or two others I mention which aid respir- 
ation and whose absence makes breathing more difficult. I 
refer to public baths and gymnasiums. 

To conclude, if the person be kept clean, a certain 
amount of physical exercise be taken, and pure air constantly 
inhaled, there is no danger whatever from tuberculosis if 
there be no heredity. Tuberculosis can be controlled. 



-88— 



STATUS OF THE BACILLUS 



"The bacteria are now admitted to belong to the veg- 
etable kingdom and to constitute the lowest forms thereof." 
— Dr. K. O. Shakespeare. 

There is a law of vegetable growth. Rationally con- 
sidered, the low form of organism or its microscopic nature 
does not militate against or invalidate this law. In other 
words, there are certain conditions which must be complied 
with in the growth of perfect vegetation. 

PLANT LIFE. 

(a) Conditions of Growth. Heat, solar or artificial, 
is necessary in the germination of every seed and in the 
fructification of every plant. Without heat plant life or 
plant growth lies dead as inorganic matter. 

There must also be moisture. Heat may awaken a 
latent energy in plant life, but if continued without mois- 
ture the agency that awakens destroys. 

Light is also a potent influence. Heat may awaken 
life, moisture may continue life, light alone perfects and 
thereby perpetuates the life begun. 

In the continuation of plant life these three factors are 
always present, and, so to speak, in an intense degree. No 
one of the three factors can be ignored. The bacteriologist 
with his culture media, etc., etc., recognizes these principles 
and applies them more or less in his field of labor. We say 
more or less. Heat is necessary; the temperature below a 
certain point little change takes place in the culture media. 
Moisture is necessary; no growth can develop without mois- 
ture. Light is necessary; with a perfect action of the other 
two, light is essential to fruition. 

In the construction of the ordinary culture oven, if a 
provision be not made for the generous admission of light, 
will the vegetation be a perfect one ? At the end of an in- 



-8 9 - 

definite series, a culture becomes attenuated. In what way ? 
There are many things a flood of light would illuminate. 

But hold ! The tubercle bacillus dies in the sunlight. 

"The tubercle bacillus dies under sunlight, in thin lay- 
ers in the course of a few minutes or hours, but perishes 
under diffuse daylight only in the course of a week." — Dr. 
Jas. T. Whittaker, Ohio Medical Journal, July, 1895. 

One other condition is necessary — a suitable soil. This 
will be referred to later on. 

(b) Modified by Environment. — Observe trees in a 
dense forest — tall, straight and without limb until near the 
top, in the crowded fence row — fan-shaped, with limbs to 
the earth; in the open — short, with branches extending in 
all directions. 

That a variable condition of the tubercle bacillus is due 
to environment is shown in an article in the Cleveland Med- 
ical Gazette, June, 1894, by Dr. C. W. F. Muenchehofe. 

(c) Elective in Location. — Sitting in a wood in Wes- 
tern Illinois I counted fourteen varieties of lumber trees on 
less than two acres in area. This is remarkable. Seldom 
do we see more than three or four varieties on so small a 
space. There are forests of oak, pine, cypress, etc. Often 
several kinds are intermingled, but usually one or two kinds 
predominate. 

The reason for this absence or predominance is prob- 
ably plant dislike or affinity for certain soils. We know 
from observation that native trees do not thrive equally well 
in all localities. There are certain spots in w T hich native 
trees refuse to grow. Change but a few 7 rods distant and 'at 
once they begin to thrive. Seeds from forest trees are scat- 
tered year by year in these waste places. They fail to take 
root and flourish. The voice of plant life is the voice of the 
maiden: I marry, but not w T hom I dislike; I grow but with 
affinity. 

In the distribution of bacteria man} T species are often 
found in the same tissue. 

"Different species of bacteria are so frequently asso- 
ciated together in substances that afford them nourishment 



-go- 
that some method of separation is essential for intelligent 
study, etc." — Dr. Shakespeare. 

At other times well nigh pure cultures are found. 

''The main habitat of, the tubercle bacillus is the lungs 
and the sputum is sometimes almost a pure culture." — Dr. 
J. T. Whittaker. 

One of the greatest difficulties in the past has been to 
isolate in order to cultivate. It is thought this difficulty is 
now entirely overcome. 

With the removal of one barrier another appears. It 
is found the germ takes root in some soils and in some it 
does not. The reason for this affinity or dislike can only be 
conjectured. Instead of explaining in a perfectly natural 
way by saying it is owing to drainage or chemical constitu- 
ents of the soil, there arises the strange hypothetical doc- 
trine of phagocytosis, which is in substance that on the part 
of host and invader armed battalions are constantly on 
guard. On the least provocation a free fight begins. As 
neither party will yield, it is a war of extermination. 

It is readily seen how such a theory could arise on the 
continent. It is an every day picture.. It is not so clear 
how such a theory could become established among intelli- 
gent Americans. But it is simply wonderful the amount of 
trans- Atlantic idol-worship that is present among us. 

On this topic, as many others, revelations will arise. 
It is to be hoped they will be more in consonance with rea- 
son and common sense. 

(d) Absorption. — This topic is taken up with a degree 
of trepidation. Plant growth is shrouded in mystery. 
What the vital principle, when enters it the plant, how 
transmitted to the seed, death occurs in what way ? — these 
and many other questions are as mysterious as life and death 
in the individual. 

The diversity in growth is involved in mystery. Two 
children, born of the same parents, reared with the same 
care, grow up together — the one virtuous, the other vicious. 
Mysterious ? Not more so than the growth of plants. 

Two seeds from the same tree are planted, the soil,, 



—9i — 

moisture and sunlight alike to each, The one is straight- 
grained, the other twisted. Mysterious ! Perhaps the 
child, by bent of inclination, received the vicious tendency 
and grew as moulded. Perhaps the embryo tree met some 
obstruction and turned in growing, remaining thus as tree. 
Mystery when made plain is mystery no longer. 

The growth of plants indifferently from the same soil 
is somewhat mysterious. The beech, the maple, the oak, 
grow side by side. It seems there must be a difference in 
the elements assimilated. 

How diversity of labor is performed on the same food 
is mystery. Three persons sit at the same table. One rises 
an orator, another a hod-carrier, the third a nothingness 
until the next meal. It seems there must be a difference in 
the elements assimilated. 

There is a difference. All living organisms grow by 
absorption, or perhaps better, assimilation. 

To the vegetable world the soil is the food. Suitable 
soil means proper elements properly prepared. Whether 
the soil be prepared by the care or folly of man it matters 
not, nature [appropriates as found. This thought should 
carefully enter the mind of every one seeking a cause or 
cure for tuberculosis. 

There is a difference. Each plant takes the element 
best suited to its nature, leaves the rest. One has more, 
another less. All must eat or die. 

Example: Mr. R. plants a field to corn for eighteen 
consecutive years. The field is occasionally fertilized as 
others. Year by year the crop of corn becomes less and less. 
On the eighteenth year there is a good growth of fodder, 
but no corn. The soil for corn is exhausted. Without fer- 
tilizer the same field yields a large crop of oats the ensuing 
season. Here is a lesson showing the value of rotation in 
crops. 

No doubt each tree takes nourishment appropriate to 
itself and leaves the rest. Another tree absorbs from what 
is left. In this is seen a gathering up of all, or Nature's 
providence. 



- 9 2 — 

But, however rich a soil may be, it avails nothing to the 
growing plant unless it be rich in assimilable elements. To 
this subject my attention was early called in planting trees. 
All things considered, those trees grew best which were 
planted with the greatest care, in having all rootlets well 
cared for and the earth well pulverized around them. This 
much for soil constituents. 

In two articles on malaria, published in the Cleveland 
Medical Gazette, September, 1891, and April, 1895, the 
question of plant absorption of an element extraneous to the 
soil is dealt with. This must suffice for the present. 

Much as is known of the life history of bacteria, their 
growth is involved in mystery. Why arise these micro- 
scopic organisms ? Is their office eliminative or destructive ? 
Does their presence in disease constitute the disease fer sef 
When once in possession of a soil, can the soil be reclaimed ? 
These and kindred questions may be asked in all earnest- 
ness, and yet the answer be a hollow mockery. 

The presence of the bacteria in disease — causal — and 
the presence 'of the same bacteria in health — harmless — is 
mysterious. 

Mystery made plain is mystery no longer. If we look 
upon the bacteria as vegetable organisms — and the highest 
authorities in the land view them as such — the way is clear. 
As already stated, all organisms grow by assimilation. 
The presence of a growing organism implies the presence of 
assimilable food. The presence of assimilable food implies 
a something before the organism takes root. 

Which has the priority, the something or the organism ? 
Will some bacteriologist please tell us in what this some- 
thing consists ? Mark the issue, in this something exists 
the cause of tuberculosis. Control this something and you 
control the disease. 

Can tuberculosis be controlled ? Per contra, the pres- 
ence of a living organism — not growing — implies the con- 
ditions are unfavorable for growth, for it is as natural for 
organisms to grow under favorable conditions as it is for 
the sun to shine or water to seek its level. If, then, other 



—93- 

conditions be the same, in health as in disease, the growth 
not being the same, the cause or causes must be sought in 
the soil. Other conditions, light, heat and moisture, are 
supposed to be the same. A fair deduction then, is, the 
difference in growth is due to a difference in the soil. 

If, then, we take this rational view of the question, it 
is unnecessary to consider the hypothetical doctrine of 
phagocytosis at all. In other words, the peace of Europe 
does not demand an armed intervention. 

But say some, "The tubercle bacillus is a parasite.'' 
What is a parasite? We will let the Standard answer: (i) 
"A living organism, either animal or plant, that lives on or 
in some other organism from which it derives its nourish- 
ment for the whole or part of its existence, as a louse, tape- 
worm, mistletoe or dodder." Yes the tubercle bacillus is a 
parasite, 

One question please: Did you ever know of a person's 
head being so healthy that a louse could not live on it ? 
Does the mistletoe invariably grow most luxuriantly on the 
tree half dead ? Look around you. Did you ever hear of 
a tape-worm being found in a healthy -primes vice? Does 
the potato beetle always select a sickly potato ? 

"Come, let us reason together." 

Why does the tubercle bacillus select a sickly subject ? 
Why does the tubercle bacillus fail to grow in the health y 
subject? 

"Your reason, Jack, your reason." "What ! upon 
compulsion ? 

Yes, armed phagocytes at the portals. 

The changes produced by the tubercle bacilli are mys- 
terious. 

"The body which we term a 'tubercle' presents in its 
earh- formation nothing distinctive or peculiar, either in its 
components or in their arrangement," — Dr. Osler. 
i. £., before bacilli enter or are planted, "tubercle" is the 
same wherever found. The bacilli enter. 

"The bacilli then cause, in the first place, a prolifera- 
tion of the fixed elements with the production of epithelioid 



—94— 

and giant cells; and, secondly, an inflammatory reaction, 
associated with the exudation of leucocytes. How far the 
leucocytes attack and destroy the bacilli has not been defi- 
nitely settled." — Dr. Osler. 

The writer has a simple taste, but he thinks when a plant 
takes root it begins to grow; that in growing it absorbs 
nourishment from the soil; that whatever the plant gains 
the soil loses. There must be change while the growth is 
going on. Change can be detected. 

All pathological talk has been on what is found in or 
after growing. What is taken up by the plant ? What is 
lost to the individual ? These are questions that should be 
answered. 

The "agreement" of modern pathologists is mystical. 
Illustration : 

"Modern pathologists have agreed in this r that only 
such products, though histologically the same or similar, as 
contain and result from the specific bacilli, deserve the name 
of tuberculosis. Thus tuberculosis is defined an infectious 
disease." — Dr. A. Jacobi. 

Suppose the farmers of Ohio should agree that, inas- 
much as a horse has so many excellent traits, he shall 
henceforth and forever be called a man. As a result of this 
agreement would the horse hereafter walk on two feet ? 

While it is perfectly right and proper for the patholo- 
gists or farmers to act as in the premises, their action or in- 
action makes no change as to facts. The- horse still re- 
mains a horse. Pathological agreements are not solid rock 
against which the medical writer can indifferently place the 
Archimedian screw. 

This is a question of mal-absorption or assimilation. 

Theological writers have been accused of cultivating a 
third eyelid. Medical writers have, and use, only two: 
Schliesze bcide Atiglein zu. 

(e) Diffusion . — The earth teems with life in the 
springtime, when plants drink the moisture and sunlight. 
The air teems with life in the summer, when plants give the 
world their fragrance. 



—95— 

Plant Absorption and Diffusion . — Thus is taught a 
great lesson in nature: Secure, give. Man has perverted 
this lesson: Acquire, hold. 

It is not primarily a lesson in charity we desire to teach; 
the rather, to study plant diffusion and observe the lesson 
therein taught as closely as we may. Perhaps this study 
can be introduced in no better way than by an illustration; 

The city of Ravenna, O,, has a water supply inferior 
to none in the state. Drawn from Crystal lake, it is dis- 
tributed through mains to various parts of the city* Being 
soft, clear and pure, it is satisfaction to all who use. At a 
certain season of the year, and for eight or ten da3 T s, usu- 
ally in July and August, the water has a peculiar taste. 
I am told this taste is due to vegetation in the lake, which 
blossoms at this period. Since the intake has been supple- 
mented by wells in the immediate vicinity of the lake the 
taste of the water is not so marked at the period named. 
At any rate, if my informant be correct, here is a clear case 
of plant diffusion through water. The aroma of flowers, 
of birch, pine, etc., is familiar to all. 

Diffusion Through the Air. — If our senses were acute 
enough to perceive them, no doubt constant change could 
be detected in the soil, due to plant absorption and diffu- 
sion. Our natural sense is too dull to perceive them, and 
the chemist is bafBed in detection. 

Query: If growing plants diffuse an entity to surround- 
ing media, Cannot the same action take place within as 
without, the body ? Or to put the question more directly 
If growing plants diffuse to a fluid media, cannot living 
bacteria diffuse to the fluids of the body ? 

If yes, may not these diffusions markedly affect the 
organism containing said bacteria ? 

Let us examine. 

"Recent chemical examinations of the contents of pure 
cultures of various pathogenic and a few other bacteria 
have shown the existence therein of certain peculiar poi- 
sons, not only possessing specific physiological action, but 
also having peculiar chemical properties and constitution.- 



- 9 6- 

which ally them more or less closely to certain well-known 
poisonous vegetable alkaloids. These chemical bodies have 
been named ptomaines." — Dr. E. O. Shakespeare. 

The willow is a native tree of North America. In the 
United States many of these trees grow along the banks of 
the smaller streams. As an anti-periodic the willow has 
long been known. The medical properties are found in the 
bark. In 1825 Fontana declared the active principle to be 
salacin. Ptomaines and salicin are then similar in each 
being developed in the living plant. 

"Pathogenic bacteria have been killed in their pure 
cultures by the action of heat. * * * The culture 
medium then injected, produces a series of symptoms, etc." 

— DR. SHAKESrEARE. 

Willow trees may be boiled, /. <?., a decoction of willow 
is made. Its administration, -per or em or injection, pro- 
duces a series of symptoms, and acts as an anti-periodic. 
Similarity is here closely allied. 

"Again, these pathogenic bacteria have been removed 
from the fluids of the pure cultures by means of filtrations. 
The filtered fluid has been inoculated with similar results." 
— Dr. Shakespeare. 

A filtration of willow yields an anti-periodic. Listen 
to the conclusion: 

"From these reasonings it would seem probable that it 
is the alkaloid developed by the growth of the bacterium 
which is the specific active agent in the production of the 
disease." — Dr. Shakespeare. 

— i. e., the writer takes it, the alkaloid passes from the 
growing plant into the fluids of the body and causes the 
disease. 

An Ideality. — John Smith, M. D., has long been a 
delver of German medical literature. He owns a farm in 
Ohio. Through this farm runs a small stream. Along 
the stream are many clumps of willow. The banks of the 
stream are shaded near its entirety. John has peculiar no- 
tions. He drinks deeply of the fatherland. His reasoning 
is as follows: "Salicin is made from willow. In order 



—97 — 

to procure salicin the willow tree is destroyed. Why this 
waste of timber? German medical literature says salicin is 
continually passing from the willow to the soil. If to the 
soil, then to the stream, for it cannot pass through the 
underlying clay. Why not boil the water and procure sali- 
cin from the stream? A perpetual annuity." John Smith 
establishes a plant for the manufacture of salicin. We will 
not speak of its capacity at this time. For some reason it 
has not grown rapidly. The neighbors think John in the 
borda'land of dementia. 

What shall we say of our dear German brothers and 
many American followers ? 

A truth is impressed which should be known to every 
observer. The fact that a plant develops or manufactures 
and stores away an element or principle in its organism 
while growing is no evidence this element or principle is of 
necessity given out in its life to surrounding media. 

As John Smith, M. D., is wrong in his reasoning that 
salicin is given off by the growing willow, so is every one 
wrong who assumes a living plant throws out its alkaloid 
during life. The writer thinks it does no such thing. 
That a plant which contains an element or principle may be 
made to yield the same by some method of filtration is 
plainly evident. That the plant tubercle bacillus does yield 
such an element by heat and filtration is known to every 
scientist. This element is the much vaunted tuberculin, 
the so-called remedy for tuberculosis. The failure of this 
remedy has been an ignominous one. Yet through all we 
see the savant Koctr the least to blame \ He thought he 
had secured a remedy for tuberculosis. Honest, though 
mistaken, mankind is fallible. Let it pass. 

John Smith, M. D., failed in the manufacture of sali- 
cin. He at once converted the plant into one for the re- 
moval of the willows. He reasons thus: "Tuberculin is 
very efficacious in the sloughing of superficial tubercular 
tissue. Tuberculin is the fluid extract of the plant tubercle 
bacillus. Salicin is the alkaloid of willow. Salicin in solu- 



- 9 8- 

tion ought to cause sloughing of superficial willow roots in 
the soil." 

Some people are always doomed to failure. John has 
met success at last. He says the solution is efficacious, but 
succeeds best if poured on the willow roots while very hot. 

In the judgment of the writer, Dr. Shakespeare is right 
in calling the ptomaine of bacteria an alkaloid; wrong in 
supposing the alkaloid passes from the growing bacterium 
to the fluids of the body. 

Say some, if tuberculin is a failure in the treatment of 
tuberculosis, it still remains the best agent known in the 
diagnosis of the disease. A locksmith is working eight 
years in the perfection of a burglar proof lock. He an- 
nounces the lock ready for trial. A committee examine the 
same and report the machine of no value as a lock, but 
in the meantime find and add: // is an excellent -plaything 
for the baby. 

What do you think of the report as to the lock ? 

So soon as treatment demonstrated tuberculin of little 
value, one would naturally think the use of the vegetable 
extract would wane. On the contrary, advocates rise in a 
night, like mushrooms in a pasture, and the remedy sells at 
fabulous prices. It is, then, not a plant diffusion, but a 
diffusion of microscopes of high power. Money flows into 
German coffers. 

Ladies and gentlemen of the profession, in all sincerity, 
is it not high time to call a halt ? Are we professional 
thinkers, or are we incorrigible asses. 

(f ) Diffusion . — Microscopy as a science[has done much 
to increase medical knowledge. Its use is recognized and 
its revelations regarded as of intrinsic worth. By its means 
certain diseases are Jnow clearly diagnosed which were for- 
merly obscure. Organisms have been discovered and de- 
scribed which hitherto existed only in belief or imagination. 
The road of the intellectual practitioner has been made 
plainer and more perfect, the thoughts elevated to a higher 
plane. No one today decries the use of the microscope. 
It has come to stay. 

Medical chemistry is also a welcome guest. During the 
last two or three decades its strides in behalf of an advanced 
profession have been great. It has opened a way by means 
of which many urinary and other diseases are clearly recog- 



—99 — 

nized and ameliorated. Its aid to the practical diagnosti- 
cian in many cases has been immense. As medical practi- 
tioners we are debtors and feel kindly for its guidance. 
Like microscopy, no one fully educated speaks lightly of the 
clearness of vision it gives in apprehending so complex a 
subject as suffering humanity. 

Microscopy and chemistry, as enlightened practitioners, 
we welcome you. 

But great as microscopy and chemistry enlarges our 
field of usefulness, something more is required than these. 
Microscopy or chemistry did not suggest gravitation to 
Newton or the glacial theory to Agassiz. The clear per- 
ception and description of animal life by Darwin was not 
given by either. 

Professional men are apt to forget and must be contin- 
ually reminded that the field of medicine is a broad field. 
He who reasons must reason from no narrow or special 
premise. The premise must be broad as the conclusion. 
The writer thinks the narrowness of the premise is a lack in 
modern methods. With this breadth of reasoning there 
must likewise be an acute observation. Without the latter 
all reasoners are apt to fail. Broad education and acute 
observation are two essentials in the advancement of medi- 
cal science. The possession of these, with a love for the 
work and an earnest desire to search only after truth, the 
progress in medicine is assured. 

There are at present two prevalent ideas. For the want 
of better terms we will name them the specialist idea and the 
generalist idea. The one is a specialist, the other a general 
practitioner in medicine. Each reasons from his especial 
field. Both claim accuracy. The specialist claims prestige 
in his particular field. This is right. Work along par- 
ticular lines ought to be better work. The generalist claims 
a greater outlook. This is right. One looking from many 
points has a clearer perspective. 

Some one thing is sought in a certain field. Who best 
to seek ? The specialist. Something is found requiring 
determination. Who best to determine? The specialist. 
Some one thing being found, who best to generalize and 
assign its field ? The generalist. Something being deter- 
mined, who best to name its systemic action? The gener- 

L.cfC. 



— IOO — 

alist. Thus each has his field of labor and each works best 
in his especial line. 

The microscope reveals a plant life in tuberculosis. 
Had not this plant life been so revealed it might never have 
been disclosed. Thanks to the specialist. This plant life 
is proclaimed the cause of tuberculosis. By whom? The 
specialist. Is he now in or out of his especial line ? If out, 
how shall we regard his judgment? The plant tubercle 
bacillus is analyzed. An alkaloid or ptomaine is discovered. 
This alkaloid is declared the active cause of symptoms in 
the disease. By whom ? The specialist. Is he now in or 
out of his especial line? If out, how shall we regard his 
judgment ? 

With these facts before us we claim acute perception or 
observation will do more in the solution of tuberculosis or, 
if you please, will do more for a suffering humanity than all 
speculations in existence. By observation it is seen (i) 
that the plant tubercle bacillus grows in certain soils — none 
other; (2) these soils are prepared for the natural reception 
and growth of the bacillus in one way — none other — abey- 
ance of atmospheric influence. Place these two proposi- 
tions together and then ask, can tuberculosis be controlled ? 

What has this to do with plant diffusion ? This is a 
diffusion of plant ideas. 

It is seen, then, that fitting or preparing a soil is all 
that is necessary. If this be all, how does plant life come 
into existence ? This may be answered in the simplicity of 
Topsy in "Uncle Tom's Cabin"; "I spec's they growed. 7 ' 
No one truly plants bacilli except the bacteriologist. He 
plants when, where and how he pleases. Selects and fits his 
own soil, cultivates or not as he deems proper, and reaps his 
reward — a harvest of bacilli. The world is little wiser. 
Did I say no one plants except the bacteriologist? Let me 
correct this statement. Every one plants who fits a soil, 
whether it be in his own person or the person of another. 
There is this difference — the planting of the bacteriologist is 
an artificial one; the planting as seen around us is a natural 
one, induced by artificial life. The one is an artificial soil 



IOI — 

Selected by man's care, the other an artificial soil induced 
by man's folly, the one an artificial soil in that nature does 
not lurk in wait with culture media and hypodermic needle, 
the other an artificial soil in that natural soil has no growing 
bacilli. Both are artificial in the sense of being either 
selected or induced. 

You say that preparing a soil is all that is necessary. 
Can a natural soil be prepared ? Yes, in from one to twelve 
weeks if the environment be favorable. What is meant by 
environment? Illustration: Take monkeys from the forest 
■ — tuberculosis unknown among them since the days of 
Adam. Place them in close rooms and examine them from 
week to week. What do you find? They are dying of 
tuberculosis. Perform the same with other warm-blooded 
animals, as man. A similar result. How do you account 
for it? Can you secure the same result by any other means 
if you allow the animal free access to the open air? But, 
says the bacteriologist, the close room means not only sus- 
pension of atmospheric influence, but also the presence of 
the bacillus. Eliminate the bacillus and will the animal 
then die of tuberculosis? The reply must be similar in na- 
ture. Are we not told the bacillus is ubiquitous ? Is it not 
everywhere present ? Can we by any possible means control 
its absence or presence ? What is the use for one to ask the 
impossible ? If the tubercle bacillus truly causes the fatal 
disease — if we cannot prevent its presence — what is the use 
of being foolish ? What we cannot amend we must endure 
We must abide the -presence of the bacillus and that which 
it causes— tuberculosis . There is therefore no hope from 
the ravages of this most intractable disease under present 
teaching. 

This seems probable from an examination of the death- 
rate from the disease in Germany, the so-called medical 
center of the universe. The American mind is pre-emi- 
nently practical. ''The way to resume is to resume," 
Why not practical in the management of tuberculosis ? It 
is seen there must be a peculiar or particular soil before the 
growth of the bacillus takes place. This soil must precede 



— 102 — 

the advent of the germ. Why not control the soil and let 
the germ care for itself. 

Suspension of atmospheric influence being the cause of 
the primary condition or precedent state, it is plainly evi- 
dent the character of the soil is under control. The soil 
under control, the disease is under control. This the 
writer thinks, is the only effectual common-sense method of 
controlling the disease. 



103— 



ABEYANCE OF ATT10SPHERIC 
INFLUENCE. 



While attending lectures at Ann Arbor, Mich., in 
1874-5, Prof. Ford clearly and forcibly demonstrated the 
nature of lung tissue. Speaking of its tenuity, he com- 
pared it to the finest tissue paper in existence. The paper 
maker's art has advanced in twenty years, but normal lung 
tissue remains the same. 

Into and through this tenuous tissue courses the life- 
giving principle, the blood; into and through this tenuous 
tissue passes the life-giving principle, the oxygen. The 
one surges from within at every heart-beat, the other surges 
from without at every inspiration. 

It is seen that in order to have perfect aeration there 
must be a normal lung tissue, a heart-beat that sends a con- 
tinuous stream of blood to every part of the lungs, an in- 
spiration that renews continually the atmosphere of the air 
cells — yet something more, the joint and harmonious action 
of the two, or a correlation of force. If from any defect in 
the organism, original or acquired, the blood or air does no fc 
reach the lungs at proper times or in proper quantities, 
aeration is defective, 

Perfect aeration means more than this. It involves a 
perfect machinery or organism plus a pure atmosphere. 
Aeration in other words is ventilation of the blood as it 
flows in the life current. As the river in its onward flow 
receives the oxygen of purification, so likewise the blood. 
The completeness of aeration is proportional to the com- 
pleteness of ventilation. If, then, the writer clearly appre- 
hends perfect aeration, it embraces primarily a normal lung 
tissue, a correlation of force and a pure atmosphere. 

While it is true digestion, circulation and aeration are 
performed by separate organs in the economy, no organ can 



- 104 — 

say its action is alone. Each is dependent on the other. 
So with the lungs. A healthy organism is then presupposed. 

The stomach, heart and lungs being supplied with the 
same arterial blood, other circumstances equal, one would 
rationally consider the function of each equally well per- 
formed. The same is true of other organs. But the nerve 
supply, which seems to designate or determine the work or 
conditions of work for each organ, is very different. So 
also is the work each organ is called to perform. 

While the stomach, heart and lungs are supplied with 
motor branches from the pneumogastric — a cranial nerve — 
the organs of respiration are also furnished with sensitive 
branches from the same nerve. In other "words, it seems a 
design of creation that the brain should control respira- 
tion. Yet not entirely, for it is seen that the three organs 
named are also supplied with branches from the sympathetic. 
But they are supplied in a very different manner, as one 
would naturally infer from the nature of the work required. 

While the stomach has a comparative paucity of plex- 
uses and ganglia, the heart has an extensive system — a 
complicated net- work — in this regard. The lungs are 
marked by ganglia on all filaments extending to the bron- 
chial tubes, and as stated, by a combined system of motor 
and sensory nerves. 

In looking over the nerve supply of the various vital 
organs one is led to inquire who can interpret the nerve 
factor of any. In attempting a solution, difficulties at once 
arise. To interpret, all the organs must be taken into ac- 
count. Imperfect knowledge of nerve supply and office, 
imperfect interpreters, etc., are some of the difficulties we 
meet. But this much is certain: The nerves are the lines 
of communication, near or remote. Sever those lines and 
communication is at an end. Suppose, instead of cutting 
the lines, we so obstruct as to break the connection. The 
result is the same, though slower. In the lungs there is 
the motor and sensory fibers of the pneumogastric. We 
inhale or exhale, forcibly or otherwise, as we choose. In 
health it is a matter of volition. Sever or obstruct one or 



. —105 — 

both of the nerves controlling respiration and the breathing 
is laborious, or under control no longer. In disease of this 
nerve, respiration is not a matter of volition. We may will 
to breathe deeply or otherwise, but have no power to exe- 
cute. The same or similar condition maintains if the brain 
or ganglia on the nerve trunk be diseased. The telegraphic 
connection is stopped or is not under perfect control. 

Again, we inhale something that irritates our lungs. 
We cough persistently, even though we desire to stop. No 
doubt it is the little tell-tale ganglia on the nerve filaments 
of the bronchial tubes that are kindly telling us of the irri- 
tation. We are admonished in this way to remove it. If 
the nerve filaments or ganglia be diseased the irritant may 
be present, yet we are not conscions of it. But mark — the 
injury entailed remains the same. 

Having tried to make plain the central and peripheric 
nerve influence, let us now consider the essentials to perfect 
aeration, and at the same time study the defects that cause 
abeyance of atmospheric influence. We do this the more 
cheerfully, for on this topic, it seems to the writer, there is 
gross ignorance and a degree of mental hebetude inconsis- 
tent with civilization. 

There is a period of growth or development in all exis- 
tence. We see this on every hand. The human system is 
no exception to this law of creation. The number of years 
allotted to man has been variously estimated by different 
writers. It seems that, while there is a general average of 
life, there can be no law that will apply to every individual. 
Each human being has a life distinctly his own. As no 
chain is stronger than its weakest link, so no being is 
stronger than his weakest organ. When we see a race, 
family or individual prone to a certain disease, we can ac- 
count for it on no other than rational principles. There can 
be nothing accidental regarding it. It must be due to 
heredity or causes external or internal. If due to heredity, 
by following up certain family lines or connections, we find 
the same disease. If, as we trace this disease back, we find 
it more or less prevalent or malignant, we make deductions 



— 106 — • 

accordingly. These are generally correct. 

There is a tendency on the part of some to speak of 
heredity as a sole causal factor in diseases showing trans- 
mission. This seems a mistake — an error that needs cor- 
rection. Should a parent have lung disease, should his 
children to the latest generation have the same disease at 
birth, one could reasonably attribute all disease of like na- 
ture to heredity. Observation does not confirm this state- 
ment. A parent with diseased lungs, or lungs of abnormal 
tissue, may transmit weak lungs, or, probably better, lungs 
of abnormal tissue. Observation shows this to be true. 
Both parents having weak or diseased lungs this law is 
doubly sure. Of either parent — the mother most certainly 
— transmits the weakness as I have elsewhere shown. This 
then, seems a law of heredity: Like transmits like. 

Why certain mental or physical characteristics or con- 
ditions, etc., are transmitted may never be fully explained, 
but their transmission cannot be denied. 

Is there another factor that aids heredity ? Suppose a 
cause be shown for the lung disease already spoken of. Sup- 
pose this cause is constantly at work. The following would 
then prevail: Abnormal lung tissue from parentage plus the 
common cause — nothing preventing — a -progression that 
would de-populate the earth. 

This, I think, is the exact condition we find in tuber- 
culosis. Tuberculosis is a systemic or constitutional dis- 
ease, due to a common cause, viz., abeyance of atmospheric 
influence. A tuberculous parent transmits a tuberculous 
tissue. A child of a tuberculous parent is prone to tuber- 
culosis. Placed in a condition of enforced suspension of 
atmospheric influence, he will assuredly die of tuberculosis; 
placed in an opposite condition, he probably will die from 
other disease. Tuberculosis has one cause — one alone — 
abeyance of atmospheric influence. 

What evidence have we of this ? The best evidence of 
cognizable facts: The evidence of our senses — intellectual 
perception. 

In what does a subject of the tubercular dyscrasia dif- 



— 107 — 

fer from the healthy or normal subject? In nothing, so far 
as known; only in proneness to tuberculosis. The tubercu- 
lar dyscrasia seems a systemic taint that weakens the entire 
human fabric; a poisoned system in which a harmful ele- 
ment is not eliminated; a system lacking in one essential — 
the oxygen of the atmosphere; a system that may be re- 
stored to the normal, through the generations by observing 
natural law ; a system destined to premature disease and 
death without invoking the aid of this law. 

In the - whole realm of disease can an analogous one be 
found ? Disease, like facial expression, is similar, yet dis- 
similar. No two faces alike — a similarity in all. Syphilis 
and tuberculosis have many similarities. 

What is abeyance of atmospheric influence ? Simply 
suspension of atmospheric influence, imperfect aeration, 
lack of ventilation of the blood. Can it be made more 
plain? This may arise from causes external or internal, or 
combined. The air we breathe contains certain essential 
elements in relative proportion. This is normal air. 
Should one in health breathe air that deviates from this 
standard it would eventually lead to disease. In other 
words, the disease would be induced by suspension of atmos- 
pheric influence. This suspension does not take place from 
external causes alone. Should one with abnormal lung 
tissue breathe normal air, the blood at the same time not 
being perfectly oxygenated, it would be just as truly an 
abeyance of atmospheric influence as in the former case. 
The result would be the same, though the conditions be 
changed. We have, then, abeyance of atmospheric influ- 
ence from external and internal causes. 

Now suppose, further— and this supposition is not an 
imaginary one — that the two conditions be found at the 
same time in the same individual, viz., abnormal lung tissue 
and abnormal atmosphere. What would result ? Disease 
doubly certain, and that, it may be, in the absence of the 
bacillus. This disease would then be induced by combined 
causes. In the opinion of the writer, the major part of tub- 
erculosis is so induced. 



— io8— 

Let us row consider severally some of the so-called 
predisposing causes of tuberculosis. It will be seen that 
whatever the ultimate result, abeyance of atmospheric in- 
fluence explains the primary condition. By primary condi- 
tion is meant the state of the patient before the entrance of 
bacilli. 

CONGENITAL. DEFECT. 

Children are brought into this world by the vicious, 
over- worked, etc., without object or aim. They are cast 
upon society as helpless waifs, a burden to mankind. It 
were better had they never been born. Without particular 
disease, they fall an easy prey to any. This is the congen- 
ital predisposition of some writers. It is seen where num- 
erous children are born of the same mother in rapid succes- 
sion. The parents may be healthy, but the period of rest 
is so short the children do not receive a requisite vitality. 
Children of this stamp readily succumb to any endemic or 
epidemic disease. Is it a wonder multitudes of these child- 
ren die of tuberculosis ? Would it not be a greater marvel, 
that any lived with so unfavorable a birth and environment ? 
Puny in development, with narrow and contracted chest 
walls, the air space for perfect breathing is not sufficient. 
Born perhaps of scrofulous or tuberculous parentage, the 
lung tissue is abnormal, and, as shown, there must be a 
consequent abeyance of atmospheric influence. Add to this 
an unfavorable environment, meaning by this absence of 
proper care, sunlight, clothing, etc.; add still further, an 
impure atmosphere, and you have a condition favorable to 
the entrance of bacilli. Do the bacilli cause the disease? 
By no means. They simply enter the tissue as a feeding 
ground. As the vulture and dead animal are found together 
so likewise the bacilli and diseased tissue. It is the condi- 
tion of the system that allows the bacilli to enter . 

HEREDITY. 

So much has already been written on this topic that it 
seems superfluous to write further. This much is certain: 
Parentage in the race of life does tell. The nearer perfect 



— log — 

the health and environment of the parents the nearer per- 
fect the child at birth. The greater the deviation from the 
normal in parentage the greater the deviation from the nor- 
mal in offspring. When writers tell us all are born alike, 
and that the differences in mankind are wholly due to bent 
of inclination, environment, etc., it seems the sanity of the 
writer should be called in question. To think the child of 
the debauche an equal competitor with the child of the up- 
right it contrary to reason and common sense. 

OCCUPATION, 

Another predisposing cause of tuberculosis is found in 
the vocation of the individual. In those trades or callings 
where the rooms are crowded or where the air space is not 
sufficient, the death-rate from tuberculosis is sensibly in- 
creased. Here it is abeyance of atmospheric influence from 
without — impure air. In those trades in which the air is 
filled with an irritant dust, which comes in contact continu- 
ally with the air cells of the lungs, the death-rate from 
tuberculosis is largely increased. Here it is abeyance of 
atmospheric influence from within, due to the irritant in the 
air. The lung tissue actually becomes thickened and dis- 
eased before the bacilli are found. Change of occupation 
frequently effects a cure. Again, we sometimes see the two 
conditions combined, viz., insufficient air space and an irri- 
tant dust. In these cases the death-rate from tuberculosis 
is still higher. Here we have abeyance of atmospheric in- 
fluence from combined causes — lack of air space and the irri- 
tant dust. Suppose the person so exposed be a subject of 
congenital defect, or the tubercular dyscrasia. We would 
then have the maximum death-rate from tuberculosis. In 
all cases it is a suspension of atmospheric influence in the 
primary condition. Thus in an enumeration of disease in 
which tuberculosis seems to invade secondarily, it will be 
found abeyance of atmospheric influence is always present. 

To summarize: The requisites of perfect aeration are 
normal lung tissue, correlation of force, and a pure atmos- 
phere. The predisposing causes of tuberculosis are: Con- 



— no— 

genital defect, heredity and occupation. The primary 
cause of tuberculosis is abeyance of atmospheric influence, 
induced by external, internal and combined causes. 

It is seen that tubercle bacilli perform a secondary role 
in the great tragedy of tuberculosis. This is the convic- 
tion of the writer, after years of careful research and 
observation. 



Ill — 



ANNOTATIONS. 



''The tubercle bacillus not being inherited, but passing 
into the body from the outside, how does it get there? 
Under what conditions does it exist there? Under what 
conditions does it pass from the outside to the inside of the 
body ? Under what conditions does it live and propogate 
there ? It is impossible to demarcate the answers to these 
questions as clearly as the questions themselves." — (Jas. B. 
Russell, B. A., M. D. LL. D., Senior Medical Officer of 
Health, Glasgow. Republished by permission by the State 
Board of Health of Massachusetts, 1896.) 

As seen in the preface of the pamphlet from which this 
extract is taken, "The subject is so clearly expressed and 
so admirably treated that the State Board of Health, with 
the consent of the author, has decided to reprint the prin- 
cipal portion for popular distribution." 

We have, then, an eminent health officer writing on a 
subject which concerns us all, and asking under what con- 
ditions the tubercle bacilli enter the system and propogate 
or grow. At the same time he positively affirms no answer 
can be made as clear as the question itself. The writer 
thinks differently. 

The scholiast recognizes five methods of obtaining in- 
formation, viz., observation, reading, listening, conversa- 
tion, meditation. Suffering has also been added. We 
briefly call attention to two or three of these methods. 

(a) Observation. Cast your eye over the field of ani- 
mate nature. Observe closely they who have tuberculosis 
and the}^ who have it not. All belong to one of two classes, 
there is no middle state. Observe the manner of life of 
these distinct classes. No nomad, no wild animal has the 
disease. Among the civilized and the domestic animals the 
disease is found in every case. 



— 112 — 

Note yet further. All civilized people and all domestic 
animals do not alike have the disease. Some take it while 
others escape. Why do not all take the disease? Why do 
any escape ? Observation again points the way. None 
have tuberculosis except they in some way have suspension 
of atmospheric influence. No suspension, no tuberculosis. 
To apply this truth clearly it is observed there is more than 
one way in which suspension of atmospheric influence takes 
place. They who think suspension means simply breath- 
ing an atmosphere in which there is less oxygen than nor- 
mal have only a superficial view of the situation. Suspen- 
sion means more than this. We use in brief a chart as 
heretofore published: 

{Impure j 111 ventilation, vocation, 

atmosphere {etc. 
Impoverished ( Overheating rooms, im- 
atmosphere ( proper ventilation, etc. 

{Defective I Original \ Heredity, 
lung tissue J Acquired f Disease, 
^ \ exposure, etc. 

Observe the inonkeys in the forest. Tuberculosis is 
unknown among them. Place these monkeys in confine- 
ment and suspend atmospheric influence in one of the many 
ways, they die of tuberculosis. Avoid the suspension, the 
monke) 7 S live. Observation affords a lesson. 

In "Boots and Saddles," when Mrs. General Cutser 
sees, in the great Northwest, the cabin and tepee side by 
side — the one unoccupied — and asks the reason, the igno- 
rant Sioux expresses a truth for all time: "I have a cough 
when living in the cabin." The Sioux knows nothing of 
germs, but he does know the cause of the cough and avoids 
it. Did he know the virtue of ventilation he could live in 
the cabin as tepee. The civilized man knows of the germ, 
but regards nothing else and dies of the cough. Which is 
the wiser? Civilization has many lessons yet to learn. 
One lesson may be learned of the untutored savage. None 
is more important! W T ill he learn it ? 

To speak clearly, there is a condition of system which 



—ii3— 

allows the entrance of the germ. This condition is pro- 
duced by suspension, which is caused in many ways as 
enumerated. In this there can be no mistake.. When Dr. 
Russell declares it is impossible to demarcate the answer as 
clearly as the question, he is mistaken. The mistake can 
be shown by putting a test question, i. e., by taking a 
healthy animal and causing suspension — the germ at once 
takes root and grows. This test may be made in the many 
ways of suspension. In this test the law of tuberculosis is 
verified. This law is founded in fact. Of this truth the 
writer is so assured he challenges controversy. 

Why is the Indian in the ill-ventilated cabin subject to 
cough, while the Indian in the tepee is immune? The rea- 
son is simple. It is the condition of the Indian that allows 
the bacilli to enter . This condition is produced, in his 
case, by ill ventilation. Nothing is more certain. Could 
it be otherwise ? 

In the writer's judgment there is no question but that 
the advent of civilization was the advent of tuberculosis. 
Must we then go back to nomadic life in order to rid our- 
selves of this dreadful scourge? By no means. All that is 
necessary is to recognize the cause of the disease and remove 
it. Nothing further is required. 

(b) Reading. "When the bacillus obtains access to 
the body of a warm-blooded animal, which it almost solely 
does by the great main entrance, the mouth, passing thence 
into one or other of the diverging channels, the windpipe 
and the gullet, it is not yet in a physiological sense inside 
the body. It must break through the mucous surfaces of 
' these passages. This is a most important stage in the ca- 
reer of the bacillus from a preventive aspect," etc. (Dr. 
Jas. B. Russell.) 

When a fire on the hearth or in the furnace is kept 
within its metes and bounds and its gentle warmth is dif- 
fused to every part of the house there is no danger from 
conflagration. The house is not yet on fire. The fire 
must break through the roof and windows of the building. 
This is a most important stage in the career of the fire from 



-114— 

a preventive aspect, etc. There is a close analogy between 
the bacillus and the fire. The bacillus in the windpipe or 
stomach is as fire on the hearth or in the furnace. So 
long as either remain there, no danger is experienced. 
When either leave, the one to grow, the other to consume, 
each becomes an element of danger. Neither can be dan- 
gerous so long as the machinery is intact. The writer thinks 
it becomes the good tenant in either case to attend to all 
needful repairs. Herein he thinks the bacteriologist is at 
fault. 

The writer desires to be honest when he asserts that 
all the bacteriologist attempts to prevent is the entrance of 
the living germ into the healthy system. This is laudatory, 
but unnecessary Living germs do not enter the healthy 
system to harm or destroy. It is the unhealthy system alone 
they harm. When a system becomes unhealthy from sus- 
pension then the so-called germ enters and propogates or 
grows. 

The bacteriologist asserts, no germ, no tuberculosis. 
The germ is wholly at fault. The writer says not so. There 
is another fault which can be prevented, and in this way the 
disease can be controlled. The fire is not at fault. The fault 
is in a defective flue or fire-box. So, the writer believes, 
the bacillus is not at fault. The fault lies in the defective 
organism in which the bacillus thrives. As stated, this de- 
fective organism is induced by suspension. This may be 
shown at any time, by direct experiment. Why not make 
it? 

It seems our present knowledge is inaccurate or at fault. 
The tubercle bacillus is spoken of as a parasite. It is a 
parasite only in the sense that it propagates or grows in dis- 
eased tissue. A true parasite attacks or attaches itself equal- 
ly well to the healthy or diseased organism. Not so the tu- 
bercle bacillus. To examine more closely the latter part of 
Dr. Russell's statement — "This is a most important stage 
in the career of the bacillus from a preventive aspect." 

Two constructions may be placed on the above. Or, 
perhaps, better, the above may be considered from two 



—ii 5 — 

stand-points : 

i. It is truly an important stage. It is the com- 
mencement of the second stage of tuberculosis, and if the 
disease be not controlled at this point in all probability it 
will not be controlled at all. Certainly this is very im- 
portant. 

2. In another sense it is not so important as may 
seem on first sight. The patient has been ailing for weeks 
or months. The bacillus is now about to enter his system 
and grow. Why wait these weeks or months ? Why not 
pre\ T ent the disease during this long period ? Why wait un- 
til the last moment ? Suppose the firemen of your village 
or city should hear the alarm of fire. Would you have them 
wait until the flame bursts from the roof and windows be- 
fore attempting to extinguish the same ? Would it not be 
better to stop the fire at the earliest moment? Why not 
apply this truth to tuberculosis ? 

Physicians are called poor collectors. Certain it is 
many die in poverty after years of toil. Is not some- 
thing else lacking ? Do not physicians lack common sense 
in the application of truth ? The writer is inclined to think 
so. If our reading is to be of avail in the betterment of 
mankind, we must examine and digest what we read and 
truly make it a part of ourselves. Without this we are the 
mere puppets of erudition, nothing more. 

(c) Meditation. "The bacillus is not inherited. As 
regards pulmonary consumption, this statement may be 
taken as absolutely true. The bacillus may pass from a 
tuberculous parent into the body of the fetus, and be born 
with it; and thus the offspring may carry into independent 
life a tuberculous process, but this fact has merely an acad- 
emic interest. Tuberculosis has been actually seen in the 
fetus with just sufficient frequency and certainty to prove 
that the inheritance of the bacillus is not impossible. For 
all practical purposes, the hygienic administrator is bound 
to regard every case of tuberculosis as caused by infection, 
which has taken place, so to speak, in the open, within the 
sphere of his control." (Dr. Jas. B. Russell.) 



-n6— 

He who observes "must ponder or meditate, else his ob- 
servations will be common as of the multitude. Apples had 
fallen since the days of Adam, but it was Newton alone who 
discovered the law of gravitation. He simply thought 
about the falling apple. He who reads must digest or 
assimilate, or his reading is of little avail. 

The fact that a tubercle bacillus may pass from a tuber- 
culous parent into the body of the fetus truly has academic 
interest. The truth that tuberculosis or the growing bacillus 
is actually found in the fetus is of greater interest and has 
wider range of application. One can readily conceive of a 
plant organism passing into the blood current of the mother 
and thence to the fetus. The finding of a growing bacillus 
in the same fetus is of wider significance. It is a thought 
worthy of our closest attention. It is proof positive a soil 
-preceded the growing -plant. How came that soil ? The 
hygienic administrator see nothing in this. "He is bound 
to regard every case of tuberculosis caused by infection." 
This statement seems truly marvelous in the light of facts: 
(i) No germ takes root in health; (2) in every case a soil 
precedes the growing plant; (3) the tuberculous parent 
transmits a soil. It is seen: No infection can take place 
unless there be a suitable soil. But the tuberculous 
parent transmits a soil, hence the hygienic administrator is 
bound to regard every child of tuberculous parentage. 
Yet more, he is bound to regard every tuberculous marriage. 
When we consider a soil is produced in one way, and must 
in every case precede the growing germ, it is high time the 
hygienic administrator recognizes this fact and acts accord- 
ingly. No such recognition or action will be taken so long 
as he firmly believes the germ theory of tuberculosis. Let 
us at once and forever discard this theory. Mankind will 
receive a marked benefit. 



= — 1 17- 



DUTIES OF THE HOUR 



To see ordinary duties postponed from time to time 
when they should be discharged at the moment is a sad 
commentary on human life, but such is seen at man's best 
estate. ''Procrastination is the thief of time." A worse 
condition is often observed; Urgent work is neglected and 
the time occupied with things of a trivial nature. 

This procrastination or putting off the essentials while 
superficialties engage the attention is a common fault and is 
due to many causes. Foremost among them is a lack of 
thought. The child at school who idles away the time 
instead of getting the lesson is doing this very thing — a lack 
of thought. In after years the thoughts come thick and 
fast when there is little time for reparation. So in man- 
hood we often take up those subjects which are truly least 
beneficial, and find in old age we have wasted our time and 
substance for naught. 

The medical man is subject to the same fault and gives 
way to the same weakness. How often we observe the 
carefulness of procedure in seeking out a so-called germ, in 
establishing its habitat and means of propogation, and then 
giving way to a childish method of disease communication 
and suppression. 

In no disease is this seen more clearly than in tuber- 
culosis. By erudition and a pains-taking accuracy it is 
determined that a plant or bacillus is found in certain con- 
ditions of the system, that in these conditions a disease is 
commonly present, known as tuberculosis, Without fur- 
ther care or thought it is at once assumed the diseased con- 
dition is caused by the plant or so-called germ. Nothing is 
more foolish. A plant growing in a certain condition is no 
evidence the plant causes the condition named. It simply 
shows a live plant has found a favorable soil. This favor- 



— lib- 
able soil may be found or determined in two ways: (i) Nat- 
ural selection or affinity; (2) transference. 

Illustration: Mr. A plows a field and weeds spring up 
in every direction — natural affinity. It may be one or more 
particular kind of weeds are found growing. Mr. B plows 
a field and sows one or more kind of grain. A transference 
is here seen. In the two cases the soil is similar, the sow- 
ing dissimilar, the fruitage or growth is like or unlike. 
The distinction is in the method in which the plant or seed 
becomes rooted in the soil, i.e., natural or artificial. In 
other words, the distinction is the way in which tuberculosis 
becomes seated in the system. The soil is alike in both 
cases. 

On this and on this alone hinge the worth or littleness 
of our knowledge in tuberculosis. On this and on this 
alone must be estimated the merit of infection or contagion. 
Is tuberculosis infectious or contagious ? Is the soil favor- 
able ? Weeds or seed do not grow unless the soil be favor- 
able; neither do germs. 

Disease extension in tuberculosis is seen on every hand . 
Why ? Its cause is wrongly interpreted. Disease suppres- 
sion is nowhere to be seen, or at best only in isolated cases. 
Why? Present methods are utterly insignificant. First 
grasp the true cause of tuberculosis, then act, not talk of 
disease suppression. 

It may be asked, is not tuberculosis less prevalent now 
than it was a few decades ago ? The disease seems less 
prevalent, but this is due not to our greater knowledge of 
germs and avoidance of them, but rather to a better method 
of living, in that we have more commodious dv^ellings, 
take more exercise in the open air, etc., etc. Advance fur- 
ther in this direction and the condition of the people will be 
yet more marked. 

Our knowledge of germs has done little if anything 
-per se in combating the ravages of this disease. That this 
statement is true every acute observer will plainly recognize. 
We see a natural and a selective affinity in the daily voca- 
tions of life. 



—ii 9 — 

Milk, on standing in the open, becomes acid or sour. 
We are told this is due to the presence of germs. Please 
observe: Conditions of the atmosphere hasten the changes 
that occur. May it not be that the condition of the atmos- 
phere prepares a suitable soil ? Is this not probable ? 
Must it not be so? If not, why should milk turn quicker in 
some atmospheres than in others ? 

If the milk be hermetically sealed no change takes 
place. Science tells us this is due to the exclusion of germs. 
Certain it is, the milk thus sealed is not subject to the 
atmospheric conditions. It is seen there are two ways to 
prevent the changing of milk: (i) Select the atmosphere; 
(2) hermetically seal. The first is difficult. The second is 
readily performed. Hence the sensible farmer or dealer in 
milk adopts the second. 

Take the lesson we learn from the action of milk and 
apply to the human system. 

In our daily rounds we meet multitudes of people who 
have, in one form or another, the disease known as tuber- 
culosis. Some have placed the proportion among the civ- 
ilized as large as three-fourths of the entire number of peo- 
ple. The writer thinks this an exaggeration, but it will be 
admitted that the exact number who have the disease, 
though large, is hard to estimate. 

Present science says the disease is caused by a germ, 
known as the tubercle baciHus. The writer denies this, but 
admits that in many cases of the disease this germ is found 
growing; in other cases the germ has not taken root. The 
disease may be in an incipient state, and all that is lacking 
is a favorable soil. So soon as the soil be favorable so soon 
is found the growing germ. A person in this condition 
may be compared to milk standing in the open. If the 
atmospheric conditions be favorable the milk turns sour, or 
the germ takes root. In the individual the growing bacillus 
is added to the already serious disease. The ailment then 
takes upon itself a two-fold nature, viz., the -prepared soil 
and the growing -plant. Herein the germ theorist is sadly 
at fault. He regards not the dual nature of the disease, 
and directs his energies to the germ alone. 



— 120 



The writer believes the average germ theorist to be 
germ proficient and common sense deficient. Knowledge is 
power, but common sense should be used in its application. 

It will be remembered there are two ways to prevent 
the change in milk. There are also two ways to prevent 
the germ's entrance and growth in the system. To her- 
metically seal the milk works admirably. Could we hermet- 
ically seal all avenues of entrance of animal life no doubt it 
would work equally well, so far as the germ's growth is 
concerned, but this cannot be done. Neither can we prac- 
tically build germ-proof houses in which to live. One 
alternative yet remains. We can control the soil in which 
the germ thrives. In other words, we can control the 
atmospheric conditions which cause the favorable soil and 
thereby control the disease. This is certainly worth know- 
ing. Its attention is a duty of the hour, an essential which 
should be regarded at once. Knowledge of this truth 
makes it reprehensible in us if we do not take heed to its 
teachings. 

What is one of the superficialties ? The tweedledum 
and tweedledee of germ infection and immunity. Immunity 
is a myth, infection an impossibility with an unfavorable 
soil. He zvho allows or causes a soil to become favorable 
should be held criminal before the lazu. 

This may seem serious talk, but in so insidious and 
deadly a disease as tuberculosis there should be no white- 
wash or red tape. All teaching should be plain common 
sense. 

An elective or selective affinity is seen by the good 
housewife in making bread. Yeast is prepared and at a 
proper stage of the proceeding is transferred and thoroughly 
mixed with the flour dough. The ferment causes the dough 
to rise, and in this way the enlarged or aerated loaf is ob- 
tained. This measure is one of convenience. The dough 
would naturally ferment or rise if the atmospheric condi- 
tions be favorable, but the action would be slow, erratic or 
irregular — hence the artificial transfer. What is the dough 
at best ? Only a favorable soil. What is the yeast ? Mul- 



121 — 

titudes of growing germs. The germs placed in a favora- 
ble soil at once take root. 

Here is a lesson in bacteriology. Certain cultures are 
procured in a similar way. Starch solution or beef bouillon 
is used as a media and germs are propogated in these. 
Now because cultures may be obtained to the fourth or fifth 
generation is no evidence the culture causes the media. 
The media is procured. The germ is procured. They are 
simply placed in continuity under favorable conditions, and 
the one affords nourishment to the other. The germs de- 
velop or grow. This is a simple but truthful explanation. 

It is marvelous to what straits the germ theorist is 
reduced in talking of these things. According to him the 
germ is all in all. It is no such thing'. The germ is only 
one factor, the media another, and the conditions a third. 
The one who rationally talks of tuberculosis must bring in 
three factors: Media, condition and germ. If he talk of 
germ alone he is one of the foolish virgins, and will soon 
borrow oil or be left in darkness. The present age is one of 
advance. Let us march forward. Tuberculosis can be con- 
trolled and the world should know it. Did I say can be? 
It is controlled and the world should know the way. The 
author endeavors to give it; accept in this spirit. 

We see an illustration of selective or elective affinity 
in the experiments made in the bacteriological laboratory. 
Cultures as above made in beef bouillon are transferred to 
the animal kingdom, as the guinea pig, dove or rabbit. 
Upon inoculation with these cultures it is found, generally 
speaking, that they continue to grow and the animal dies of 
a disease similar or like the one from which the original 
germ was taken. This is assumed as proof positive that the 
germ so found is the cause of the disease. Let us not be 
too hasty in our conclusions. Assumption in every case is 
not found to be truth. 

We stated three conditions are necessary in order to 
have the transfer or artificial removal a success, viz., media, 
condition and germ. The germ selected is, of course, a live 
or proper one. The condition is of the live animal, warm 



— 122 — 

and moist, the most suitable. The media must afford nour- 
ishment, else the plant would not thrive. What more do we 
wish ? What does the experiment prove ? Simply that 
plant growth will thrive in the live animal, or under vary- 
ing circumstances. Does it prove that the germ causes the 
disease ? By no means. In the first place, live animals, in 
their normal condition, in the open air, never have germs 
growing in their system. The placing of them there is an 
artificialty. If naturally, in health, they do not enter the 
system and grow, how can we establish that the artificial 
insertion is the natural cause of the disease ? Such reason- 
ing is unworthy the school boy. Yet such reasoning passes 
for science. 

A short time since the writer was invited by his friend, 
Dr. Dudley P. Allen, to walk through the various apart- 
ments of the L,akeside Hospital Cleveland, O. Among 
others he pointed out the rooms for microscopical and bac- 
teriological experiments. I saw in little crates or cages, 
doves, rabbits, guinea pigs, etc., and thought in passing, 
here is an artificial condition for natural entrance of germs. 
The transfer made in the laboratory, like the transfer made 
by the good housewife, is an artificial one for convenience. 
It is more speedy. But in either case it proves nothing ex- 
cept germs thrive and propogate in a variety of media. 
When will we learn wisdom ? Certainly we have not as yet. 

For a natural entrance of growing germs there must be 
a prepared soil. Whether we prepare the soil ignorantly or 
wisely, the germ alike takes root and grows. If we prevent 
the formation of soil, we prevent the growth. Here is the 
true secret of all tubercular disease. 

Tuberculosis is a disease of civilization caused by sus- 
pension of atmospheric influence, in that the suspension 
prepares the soil for vegetable growth. 

The disease is governed by the following law: The 
death-rate from tuberculosis is in direct ratio to suspension 
of atmospheric influence. 

What, then, are the duties of the hour ? To prevent 
suspension in every conceivable way. 



123- 



A CATECHISM 



What is tuberculosis ? A constitutional disease depen- 
dent largely on the evils of civilization, and governed by 
the following law: The death-rate from tuberculosis is in 
direct ratio to suspension of atmospheric influence. 

Do not standard medical writings tell us tuberculosis is 
caused by the germ tubercle bacillus? Yes, they so in- 
form us. 

Is not the consensus of medical opinion, as found in 
those writings more likely to be correct and of consequent 
greater worth than individual opinion ? Yes, this is true as 
a general proposition. 

Why, then, should one persist in saying tuberculosis is 
caused by suspension of atmospheric influence ? Ever}- one 
as a witness, should tell "the truth, the whole truth and 
nothing but the truth." 

We are witnesses. As such, must we agree with the 
multitude or tell that we know? The upright judge 
would say, *' Tell that you know.''' Again, no body of men 
is infallible. Because the multitude say a statement is cor- 
rect is no reason it is so. 

Is not the presence or absenc e of tubercle bacilli in the 
tissue an evidence of the presence or absence of tuberculosis? 
Listen to an authority: "The tubercle bacillus is ubiquitous." 

Is not a growing bacillus in one's system an evidence 
of tuberculosis ? Yes, but the growing bacillus implies a 
precedent state. Without this state the bacillus does not 
grow. The tubercle bacillus is not found growing in the 
healthy system. 

The question now arises, which is the primal cause of 
tuberculosis, the precedent state — suspension — or the tuber- 
cle bacillus? Look around you ! Which takes preced- 
ence, the growing plant or the soil in which it grows. 
In every case, the soil. 



-124- 

Which is, then, the primary cause of tuberculosis? 
One answer: The soil — the precedent state — or suspension 
of atmospheric influence. 

Having determined the primary cause of tuberculosis, 
let us now proceed. 

Mr. A has tuberculosis. Mr. B has the precedent 
state. Will the writer please tell us the difference in these 
cases ? Mr. A has the precedent state plus the growing 
tubercle bacillus; Mr. B has the precedent state. Messrs. 
A and B each have tuberculosis. 

Tuberculosis may exist in the absence of tubercle ba- 
cilli, but can never exist without the -precedent state. 
Herein lies the error of the savant Koch. He has mis- 
taken the cause of tuberculosis. His attention has been 
directed alone to the germ tubercle bacillus. 

Tuberculosis is not caused by the tubercle bacillus. It 
is due to suspension of atmospheric influence, is based on 
law and can be controlled. 

To be clearly understood, the writer makes tuberculosis 
more comprehensive. The term includes: 

i. All cases in which the growing bacilli are found. 
2. All cases in which the condition of the system is 
such as to allow the tubercle bacilli to take root. Should 
we classify: 

First stage, prior to entrance of bacilli — subject to 
control. 

Second stage, after entrance of bacilli — amenable to 
treatment. 

Third stage, breaking down of 'tissue — treatment of 
little avail. 

Having shown the plant growth is a secondary condi- 
tion or modifying influence in this most fatal disease, we 
would now call attention to modern treatment as directed 
against this growth or supposed cause. We do this the 
more willingly feeling assured this treatment must ever be 
barren of permanent curative results, and at times danger- 
ous to the patient. 

What is tuberculin ? As first given the public, tuber- 



— 125 — 

culin is a glycerine extract of tubercle bacilli cultures. 

Judging from observation, of what use is tuberculin? 
Largely commercial. 

Has tuberculin value ? Yes. Illustration: Mr. A has 
tuberculosis, as ordinarily defined, i. e. y the precedent state 
plus growing tubercle bacilli. Here it has value. That 
there be no mistake in this matter, we quote no less an 
authority than Prof. Jas. T. Whittaker; "The value of 
tuberculin in the diagnosis of the disease in cattle is univer- 
sally accepted. According to the report of Salmon, thus 
far we have yet to meet the first case which reacted and did 
not show tuberculosis upon post mortem examination." — ■ 
Lancet-Clinic, Sept. n, 1897. *"• e *i tuberculosis as ordi- 
narily defined. 

(a) Tuberculin determines the presence of growing 
bacilli. 

Today, as then, these words are true. All tuberculin 
determines is the presence of growing tubercle bacilli. 
Hundreds of cattle stand in their stalls with the precedent 
state. Thousands may likewise stand in favorable condi- 
tions to. produce this state. Of these tuberculin says nothing. 

This leads to another question, has tuberculin value in 
diagnosis? No. Illustration: Mr. B has the precedent 
state, i. e. , tuberculosis as defined by the writer — no grow- 
ing bacilli induced by suspension of atmospheric influence, 
(Please observe Mr. B has the symptoms of tuberculosis as 
found in the first stage of the disease.) 

An injection of tuberculin is made; no reaction. What 
does this injection determine? 

(b) Tuberculin has no value in diagnosis. 

But if there be stages in the disease tuberculosis, the 
first designated by absence, the second by presence of grow- 
ing tubercle bacilli; if tuberculin determine the presence or 
absence of these, is not the extract useful ? 

When the writer remembers the first stage is subject to 
control, the second simply amenable to treatment, this fact 
appears valuable should we possess an accurate means of 
determination. It is known to every practitioner that tub- 



— 126 — 

erculosis in its first stage is difficult to detect. The stage 
being determined, the physician knows for a certainty the 
result to expect from treatment — a very valuable acquisition. 

Can we with certainty differentiate the first stage by 
means of tuberculin ? No. Illustration; Mr. C is sick and 
calls on his physician. The symptoms simulate malaria. 
The blood is examined; no plasmodium found. A tenta- 
tive injection of tuberculin is made; no reaction. What 
does this determine? The absence of growing bacilli. 

It has been shown that growing bacilli are absent in 
health. They are absent in many diseases. The mere ab- 
sence of growing bacilli does not determine the first stage 
of tuberculosis; therefore: 

(c) Tuberculin has no certain value in differentia- 
tion of ffrst stage. 

Is the use of tuberculin dangerous ? Yes and no. 
Illustration: Mr. D is ailing. He has symptoms of incip- 
ient tuberculosis, or the precedent state. He has reason to 
fear tuberculosis in the first stage, for his occupation and 
manner of life are such as to induce this state. He asks his 
physician, who is a noted bacteriologist, if there be anyway 
to determine whether he has tuberculosis or not. The doc- 
tor replies: "The science of medicine has made rapid ad- 
vances. When you were a boy this could not be deter- 
mined. Now it is as simple as A, B, C. Dr. Koch de- 
serves the gratitude of mankind. ' ' An injection of tubercu- 
lin is made; no reaction. The patient is assured; "Your 
fears are groundless; no tuberculosis whatever." (It must 
be remembered the precedent state is the condition of the 
system in which the living tubercle bacillus takes root.) 

What is the actual result ? Mr. D passes rapidly from 
the first to the second stage of tuberculosis — from a curable 
to an incurable condition. 

What is the actual result ? Mistaken diagnosis, loss of 
confidence in the physician, death of the patient. 

(d) Tuberculin is sometimes dangerous. 

True, the patient is dead. Can it be shown tuberculin 
is the cause of death ? Has not Prof. Whittaker told us he 



—127— 

has used tuberculin every day in hospital and private prac- 
tice for six years, in now nearly one thousand cases, and has 
never seen any kind of evil result? Does not Prof. Koch 
say in substance that tuberculin is perfectly innocuous ? 
Why decry tuberculin ? 

That there be no misrepresentation we quote from the 
published writings of Koch, as translated by J. T. W. 
( Lancet- Clime, April 24, 1897); ''Only the most extremely 
virulent cultures should be used in the preparation of TR 
. . . They must be prepared as fresh as possible . . 
. I consider it out of the question to produce TR in 
large quantities with the hands .... At my sugges- 
tion, apparatus for whoesale manufacture has been pro- 
vided." 

Listen to what follows concerning Prof. Koch's new 
tuberculin: "In regard to TR, it has been subjected to 
much criticism, both on account of the failure in some hands 
to obtain hoped-for results, and on account of the impurity 
of some of the samples that have been sent out by the firm 
that have been allowed by Koch to manufacture this prod- 
uct for the market.'' Again: "According to Trudeau and 
Baldwin, some tuberculosis bacilli may be found in the 
preparation." (Bulletin of the Pasteur Institute, July, 
August and September. ) 

After reading the above it seems further comment is 
unnecessary. 

Is tuberculin dangerous? No, if perfectly pure and 
injected with proper precautions, 

To summarize: The injection of tuberculin determines 
the presence or absence of growing bacilli, is of no value in 
diagnosis of tuberculosis, of uncertain value in differentia- 
tion of first stage of the disease, and is sometimes dangerous. 

It is seen from the above that the intrinsic value of 
tuberculin is small, while, under existing circumstances, its 
commercial value may be great. 

What of tuberculin in treatment ? When Prof. Andree 
launched his balloon in search of the pole he began a peril- 
ous journey; result unknown. So when one promises cure 



-128 — 

of disease not understood, he is traveling — no one knows 
whither. 

What is a constitutional disease ? The word constitu- 
tional is significant. When that prince of cynics, Thomas 
Carlyle, took a walk for the good of his health, he spoke of 
it as a "constitutional" — conveying the idea, as the writer 
thinks, that physical exercise in the open air builds up the 
entire system. 

When one speaks of a constitutional disease he means a 
systemic ailment that primarily is taking away or destroy- 
ing the life or vigor of the entire organism. 

The word constitutional is used in contra-distinction to 
local. Should one in the prime of life gradually decline in 
physical and mental vigor, we properly designate this a 
constitutional disease. Should one have an ailment in one 
part or member of the body, we properly designate this a 
local disease. 

In medicine constitutional and local are relative terms 
used to point out the extent of invasion. If applied to 
treatment they respectively represent the whole or part of 
the system for which the remedies are taken or applied. 

From the very nature of the case, when one has a con- 
stitutional disease he frequently has local symptoms. Per 
contra, when one has local disease he frequently has con- 
stitutional symptoms. 

Our system is so connected and complex, one part be- 
ing dependent on another, that when one member is dis- 
eased the entire system suffers; when the system is diseased 
individual members suffer in a greater or less degree. 

These remarks may seem common-place. They are 
common language used to make plain the nature of a con- 
stitutional disease. 

The writer takes it, a constitutional disease is a disease 
of the entire organism, and that primarily. 

Is tuberculosis a constitutional disease? On this, as 
many other subjects, writers fail to be lucid. If we attri- 
bute the diseased condition found in tuberculosis to the 
action of the germ tubercle bacillus alone, as is the common 



— 129 — 

sentiment of the medical profession today; if the tubercle 
bacillus capture and kill its subjects, as a fox a lamb in the 
open, tuberculosis may be regarded a local or infectious 
disease. The writer is unwilling to accord so potent an in- 
fluence to the plant. 

We are told one takes tuberculosis as he takes measles, 
etc. The inception of tuberculosis is a question of expos- 
ure. As the majority of mankind have measles at some 
period of their existence, so the majority have tuberculosis. 
As some do not "catch" measles, so some do not 'take" 
tuberculosis. This seems very simple. 

Is this view strictly correct ? Let us examine this sub- 
ject a little more closely. The tubercle bacillus is a plant 
growth. Like all vegetable organisms, the plant must have 
a soil in which to develop. True, the soil for the vegetable 
growth is found in a living animal, but please observe the 
soil -per se is a dead or partially disorganized tissue. Must 
it not, of necessity, be so? 

Science tells us that plant life can assimilate only the 
simplest forms of food; that tissue of the living animal is 
food not in its simplest form. Therefore, the living tuber- 
cle bacillus -per se cannot take root in the living animal. 
Hence, a soil must be prepared before the reception of its 
host. 

For an author to state that tuberculosis is caused by a 
germ, and is received in the same way as measles, etc., is, 
to say the least, an expression of ideas w T ith little reflec- 
tion. The method of infection in measles and tuberculosis 
is very different. Is it necessary to prepare a soil for the 
inception of measles ? Can we in any way so prepare a soil ? 
Is a soil prepared in every case of tuberculosis before the 
bacilli can take root ? Yes, in every case. Can we so pre- 
pare a soil? That we can must be evident to every ob- 
server. 

Illustration: Take a number of monkeys from the for- 
est. In their natural state ^tuberculosis is unknown among 
them. Place these monkeys in confinement, with poor ven- 
tilation, for a few days. It will be found that not some but 



-130— 

all have the precedent state or soil necessary for the growth 
of tubercle bacilli. It will be found in a short time that 
not some but all have tuberculosis. 

In an exposure to measles some few escape; not so in 
tuberculosis, if the soil be prepared. 

It may be asked, does not confinement -per se aid in the 
production of the precedent state ? This is answered most 
emphatically in the affirmative. 

We have shown suspension may take place from within 
or from without. We have shown that exercise in the open 
air prevents the precedent state. To now speak of confine^ 
ment as an aid to the precedent state seems superfluous. 
Confinement or lack of physical exercise must, of necessity, 
be an aid in its production. 

One writer says tuberculosis is a disease of the nervous 
system. He reasons: In every case of tuberculosis the ner- 
vous system is involved. 

Another might say tuberculosis is a disease of the mus- 
cles, for in every case the muscles are wasted. 

A third might say it is a disease of the osseous system, 
etc., etc. 

The truth lies here: Tuberculosis is not a disease pri- 
marily of any one isolated system, but is a constitutional 
disease. As such it includes everything in the physical 
make-up of the organism. The truth of this assertion can 
be verified by any observer or pathologist. 

L,et us for the moment lay aside the idea of germs and 
calmly consider the pathological condition as found. One 
has phthisis pulmonalis — tuberculosis of the lungs; another, 
tabes mesenterica — tuberculosis of the mesentery; a third- 
receives an injury, an amputation is performed, and tuber- 
culosis develops in a partially healed stump, etc., etc. It is 
seen the pathological condition is found in many organs of 
the body. While one organ — the lung — has a preeminence 
in this regard, yet the fact of finding tubercle in every organ 
would lead one to suppose a constitutional dyscrasia pre- 
ceded the pathological condition. In other \^ords, that tub- 
erculosis is a constitutional disease before the formation of 
tubercle. 



—i3i— 

Why one organ is predisposed in one individual and 
another in another is perhaps due to an innate weakness, of 
that particular organ. 

It is generally found that when tuberculosis of one 
organ causes death, the evidence of the disease is not local, 
but systemic, showing a condition of system preceded the 
local condition. 

But, say some, "How can these things be ?" Does not 
the bacteriologist inject tubercle bacilli cultures into the 
healthy living guinea-pig, and do they not grow? Why 
should one say a soil must be prepared ? 

Another question: "Do these bacilli naturally grow in 
the tissue of the healthy living guinea-pig?" Is not the 
method of injection an unnatural method? In seeking nat- 
ural results why not use natural methods? For tubercle 
bacilli to grow in a natural or spontaneous manner a soil 
must be prepared. 

Let every biologist in the land take this truth to his 
laboratory and ponder it in his heart. Let him ponder with 
the slide of his microscope intact. Then will he truly learn 
the science of life. 

What is meant by civilization ? 

"An improved condition of man resulting from the 
establishment of social order in place of the individual in- 
dependence and lawlessness of the savage or barbarous life. 
It may exist in various degrees; it is susceptible of continual 
progress." — (Guizot', -translation by Hazlitt.) 

Do we understand civilization has evils ? 

As Guizot has put it, civilization is an improved condi- 
tion. Let no one assume the life of the savage is equal to 
the life of the civilized. A just comparison places savagery 
far in the back-ground. Should any doubt this let him com- 
pare the condition of woman in the two stages of existence. 
In savage life she is the menial of man, subject to his ca- 
price; in civilized life his equal in every regard. Nowhere 
today do we see the savage exalted except perhaps in poet- 
ical effusion. 

The author quoted tells us civilization exists in various 



- 132— 

degrees. For example, the civilization of the United States 
in 1 897 is not the civilization of Spain for the same year. 
There is an immense difference. 

Again, civilization is susceptible of continual progress. 
No nation or people have, as yet, arrived at an ideal of civ- 
ilization. As the Methodist brother puts it, "We must go 
on unto perfection." 

If civilization be not yet perfect, evils must exist. To 
what particular evils does the writer refer ? 

Only to those which cause suspension of atmospheric 
influence, or the precedent state. In other words, only 
those which cause tuberculosis. 

What is one of the most flagrant evils of civilization ? 

Ill ventilation: (a) In the home; (b) in the work shop; 
(c) in the public hall or conveyance. 

(a) The writer's attention was called to the remarks of 
some poor immigrants: "What lovely homes ! Do the peo- 
ple own these? How did they get them ? In our country 
no one owns homes except the rich." A sad commentary 
on European civilization. Will it ever be so in America? 
The bulwark of strength in our land today is the home. 
Churches ma3^ rise and fall, nations come and go, but the 
home is sacred and should remain. To the home we are at- 
tracted and tied. 

In building the home or temporal structure in which 
we live, mankind is fallible. We build too large or small, 
or not in accord with the laws of nature or of health. We 
build each after his own model or ideal, and our houses dif- 
fer as our judgment. "Each thinks his correct." As mis- 
placed confidence in marriage wrecks the happiness of the 
earthly home, so building ill-contrived or ill-constructed 
houses wrecks the happiness and health of those who in 
them dwell. 

In obstetric practice we are often called into homes in 
which the bedroom or sleeping apartment is the smallest 
room in the house. This is a mistake; it should be the 
largest. In close apartments the air is breathed and re- 
breathed many times during the night. 



—133— 

In the selection of a furnace or heating apparatus mis- 
takes are made. Furnaces, in general, are too small. The 
furnace should at least be double the capacity required in 
cold weather. There is then no white or red heat of the 
furnace to abstract oxygen. It has been already shown 
that impure or impoverished air causes suspension of atmos- 
pheric influence or the precedent state. Herein lies the 
secret of the so-called infectiousness of tuberculosis. 

Tuberculosis is never infectious in a pure atmosphere. 
Tuberculosis is ever infectious in an impure atmosphere. 

What is the lesson taught ? To ever keep the atmos- 
phere pure. 

To summarize: Each resident in America who builds a 
home builds as best suits his judgment. In construction 
little regard is paid to ventilation. This is perfectly natu- 
ral, for present teaching seems to be how to render the 
home germ proof. 

(b) In one sense our work-shop is our home. One is 
an attorney, another a merchant, another an artisan, etc. 
Each is engaged in his vocation a certain number of hours 
per day. For these hours his shop or office is his home. 
The laws of health apply as in the home. The ventilation 
and heating should be on the same principle — an abundant 
supply of pure air. 

To the artisan in his shop there is an element of dust or 
vapor with which he must contend. This increases the 
danger from tuberculosis in that it increases the suspension 
of atmospheric influence from without. 

Who has not observed the increased death-rate from 
tuberculosis in the artisan ? Have you ever thought this 
increase was due to excess of germs in the little shop in which 
he works single-handed? In the writer's judgment, the 
increased death-rate is not due to excess of germs, but to 
suspension of atmospheric influence from without. The 
germs then enter. 

In the larger shops there are often three factors at 
work at one and the same time: (i) Insufficient air space, 
consequent rebreathing or air impoverishment; (2) poor 



-134 — 

ventilation, to prevent draughts or to keep out the cold — 
therefore, impure air; (3) the irritant dust or suspension 
from without. Add to these, heredity,, low vital resistance, 
etc. Is it any wonder multitudes thus placed readily suc- 
cumb to tuberculosis ? 

Please look at the question from a rational standpoint. 
Would you think a disease thus caused could be prevented 
or cured by other principles than those of common sense ? 

What would be a teaching of common sense ? ( 1 ) 
Abundance of pure air; (2) elimination of the irritant dust; 
(3) all workmen, with an hereditary taint excused. 

What is present teaching? (1) Artificial immunity — 
injection of tuberculin; (2) prevention of infection — cupsi- 
dors partially filled with water, into which, all workmen are 
taught to spit. The comparative merit of the two methods 
of prevention is left to an intelligent profession. 

(c) The people who continuously dwell in close houses, 
who assemble in close public halls and churches, are the 
civilized. The people who continuously suffer most from 
the dread disease, tuberculosis, are the civilized. These 
two statements must ever be born in mind. 

Of civilization and tuberculosis, which precedes the 
other ? 

In one sense there is no precedence. Where we find 
the one, there we find the other also. Civilization and tub- 
erculosis, like twin sisters, walk hand in hand. In point of 
time there is precedence. 

Civilization has evils. Civilization must exist before 
evils develop. In this sense civilization precedes the evils 
and the disease rapidly follows— cause and effect — the one 
shrouded in the mysticism of the ages, the other plain as 
the noon -day sun. 

Can nothing be done to avert the calamity that has fal- 
len upon us as a civilized people ? 

So long as students in medicine are taught that tuber- 
culosis is due to a germ; that immunity may be secured by 
injection of tuberculin, so long there will be no true pro- 
gress in prevention and control of the disease. So soon as. 






5D~ 



we grasp the true or primary cause of tuberculosis — susperr- 
sion of atmospheric influence — so soon we take the first step 
in prevention and control. There can be no definite action 
until there is clear af prehension. 

Perhaps no great nation of the earth has better inter^ 
communication than the United States. A famine in our 
land would be well nigh an impossibility. One wishes to 
travel; he has only to select his route and trains pass and 
repass by day or night at his very door. It seems perfection , 

Did you ever think of the inconveniences of travel ? 
We refer more particularly to the irritant dust or smoke of 
the cars; of the close and vile air contained in them. Have 
you ever experienced these? The same inconveniences of 
travel are found on many crowded thoroughfares of our 
large cities. Day by day we see every available space 
taken. Standing room is at a premium, for in standing one 
occasionally gets a breath of fresh air as the door is opened. 

To what danger are we exposed in these closed coaches 
and assembly halls ? Suspension of atmospheric influence — 
the precedent state — incipient tuberculosis. 

Does not the danger consist in infection from the germ 
tubercle bacillus ? As already stated, infection cannot take 
-place unless one has the precedent stat-e. This state is in- 
duced by suspension, avoided by breathing pure air. 

What, then, is the preventive? 

An abundant supply of pure air. 

The way to cure disease most speedily has long been 
sought in the practice of medicine. Human judgment is 
ever at variance as to method, a clear indication that nc 
perfect wsy has as yet been found. 

One thing the present generation has taught us: The 
necessity of prevention. In this regard no century of his- 
tory can show a brighter record. We are entering the por- 
tals of a millennium. God hasten the illumination. 

Truly, who can cure tuberculosis? No one. Who -can 
prevent the disease? Only he who understands its cause. 
The study of causal conditions in tuberculosis should there- 
fore be our highest aim . Let us ever keep this thought in 
mind. 



-136- 

In how many ways is suspension of atmospheric influ- 
ence induced ? Suspension may take place from within or 
from without. From without through impure or impov- 
erished atmosphere; from within through defective lung 
tissue, original or acquired. 

When is an atmosphere impure? An atmosphere is 
impure when it contains a mechanical or chemical irritant. 
In grinding on an emery wheel, or in certain vocations in 
stone work, etc., the dust irritates the lungs, or collects on 
the mucous surface, and thereby suspends atmospheric in- 
fluence. The same suspension is found in vocations in which 
the irritant is a gas or vapor, etc. 

When is an atmosphere impoverished? When, from 
over-heating of rooms, improper ventilation, etc., the oxy- 
gen in the air is less than normal. 

How does impoverished atmosphere produce suspension 
of atmospheric influence ? A certain amount of oxygen is 
necessary at each inspiration to properly aerate the blood. 
If oxygen be deficient in the air the respirations must be 
hurried, or else the blood is not aerated. Imperfect aera- 
tion is suspension of atmospheric influence. 

A careful study of the death-rate from tuberculosis will 
show it is largely increased in cases of suspension of atmos- 
pheric influence from without. 

To what extent is the death-rate increased ? In pro- 
portion to suspension of atmospheric influence. Let us see 
if this be true. Here are two men doing like work in the 
same room. One dies of tuberculosis, the other continues 
at his work. Why this marked difference? 

i. Heredity. If heredity and environment be the 
same, like results could be anticipated, not otherwise. 

2. Home life during nou- working hours. If the same, 
like results. 

3. Vital resistance. Mankind are not born alike in 
power to endure; If so, there is inequality in vital resistance. 

If heredity, home life and vital resistance be the same, 
we should expect similar results. At the same time, what- 
ever the comparison, it will be found that suspension of at- 



—137— 

mospheric influence induced the precedent state. Without 
this there could, be no tuberculosis. 

What is meant by defective lung tissue ? The word 
defective is used in its ordinary sense. If a limb be defec- 
tive it is in some way weakened or deformed; if a fruit or 
growth be defective it is not perfect. So in lung tissue. 
Defective lung tissue is not perfect, does not perform its 
normal functions. The function of lung tissue is to ensure 
perfect aeration of the blood. If this tissue be inflamed or 
thickened it is defective; if it be permanently thickened, or 
if it be of abnormal tissue, its function is weakened or 
destroyed . 

A lung tissue may also be impaired temporarily or per- 
manently. This impairment may be due to heredity or ac- 
quisition. If to heredity, one is responsible for results only 
as to using the one talent aright; one talent is all that is 
granted. If to acquisition, one is responsible not only for 
the right use of the talent remaining, but also for thelo^sof 
the many talents bestowed. 

Profit and loss are seen in life as in business. Should 
we recklessly throw away our God-given faculties there is 
no one to blame but ourselves. If we use and strengthen 
those granted us, it is all a reasonable creator could ask or 
creature desire. 

To any who closely study disease it is seen that the off- 
spring of defectives are defective. It is also seen that one 
cannot recklessly throw away a treasure and at the same 
time have it. 

To those who study tuberculosis it is seen that children 
of tuberculous parents are generally tuberculous. It must 
also be seen that there are certain acquired conditions which 
predispose to tuberculosis. In a tuberculous offspring there 
is original defective lung tissue — suspension of atmospheric 
influence, the precedent state. In other cases, as in measles, 
pertussis, etc., there is an acquired defective lung tissue — 
suspension of atmospheric influence, the precedent state. 

To recapitulate: The precedent state or incipient' tub- 
erculosis is caused by suspension of atmospheric influence. 



- 138— 



Suspension of 

atmospheric 

influence. 



From 
without 



From 
within 



f Impure f 111 ventilation, 

| atmosphere { vocation, etc. 
<J f Over-heating 

Impoverished ■< rooms, improper 
, atmosphere (ventilation, etc. 
r { Original: Heredity 

\ Defective f Disease 



1 lung tissue j Acquired -j expos- 

t (ure, etc 

' The law of tuberculosis expresses it more tersely: The 

death-rate from tuberculosis is in direct ratio to suspension 

of atmospheric influence. 

There have been many solutions of the sphinx-like rid- 
dle, tuberculosis. The writer thinks the above will stand 
all tests. 

Let us resume our catechism. Why should measles 
and pertussis be placed in the category as causing acquired 
defective lung tissue and pneumonia left out ? It is true, 
tuberculosis sometimes follows pneumonia. The writer is 
inclined to think pneumonia more often supervenes upon an 
unrecognized incipient tuberculosis. The pneumonia runs 
its course and then tuberculosis, at this stage, is diagnosed. 
To answer the question more direct: in measles the rash 
covers the entire surface, cutaneous and mucous. During 
the eruption suspension of atmospheric influence must take 
place. The eruption disappears,, but sometimes leaves an 
inflammatory thickening in the lungs. This causes con- 
tinued suspension of atmospheric influence, or the precedent 
state. The bacillus then enters and takes root. 

A double pneumonia is fatal. Isobar pneumonia usu- 
ally involves but a portion of one or both lungs. While 
this portion is involved the rest of the lung acts perfectly, 
but, of course, respiration is quickened. Hence no suspen- 
sion. The disease is of short duration and recovery is perfect. 

In pertussis there seems to be a continued inflammatory 
action,, which leads to thickening — suspension or the pre- 
cedent state. 

Observation shows tuberculosis often follows the above 
diseases. The explanation given seems the most sensible 
and comprehensive. 



—139— 

It is fabled when Methuselah was 500 years of age, an 
angel awoke him and said: ''Arise, Methuselah, get thee up 
and build thee an house for thou art yet to live 500 years. ' ' 

The reply of Methuselah is characteristic of a man in 
the prime of life. Said he: "If I am to live but 500 years 
why should I build me an house?" 

Whether the age of Methuselah be taken in a literal 
sense or not, this much is certain: Life at present is short- 
ened in years. 

Whether Methuselah lived in the open his entire so- 
journ or not this much is certain: The present manner of 
life shortens our years. 

What is a common cause of tuberculosis ? Let us ex- 
amine. If the animal kingdom be taken as a whole we find 
two classes: They who roam at will and they who are sub- 
ject to the will of another. Or perhaps better, they who of 
necessity take physical exercise in the open air and they 
who from choice, or otherwise, do not take such exercise. 

Of the former class, w r e find all wild animals and all 
nomadic tribes, as the aborigines of our country. 

Of the latter class, all domestic animals and all civilized 
people, as the Americans and Europeans of today. 

Among the former, tuberculosis is unknown. Among 
the latter no less than one-seventh die of the disease. A 
marked contrast. Of the wild animals it is verily a ' 'struggle 
for existence." 

One animal is preying, on another, so each is on the 
alert. If it be not the pangs of hunger that cause exertion 
it is the fear of having to appease the hunger of another 
animal. 

So physical exercise is a matter of necessity. Activity 
is life. 

It is mainly so of an uncivilized people. The struggle 
for existence is dominant. The females perform all man- 
ual labor, the males are trained in war and the chase. War 
and the chase are constant occupations. The tribes are 
constantly moving and live in the open air. 

As before stated, none die of tuberculosis. With 



— 140— 

domestic animals the case is different. The pet cat or pug 
sits quietly by the fire and lives wholly in the home. They 
are fed as the family and ofttimes receive greater attention. 

The domestic animal is fed and housed as the individ- 
ual owner. The stabled cow, the penned sheep, the unused 
horse are treated in like manner. 

Is tuberculosis prevalent among them ? Yes, and please 
note the prevalence is in accordance to the law of- tubercu- 
losis. The death-rate from tuberculosis is in direct ratio to 
suspension of atmospheric influence. 

Did you ever know of a daily used race horse dying of 
tuberculosis ? 

Do not unused stable-fed horses die of tuberculosis ? 
Why the difference ? Lack of physical exercise — suspension 
of atmospheric influence. 

This statement is also true of the work horse. A 
horse constantly used in the open air seldom dies of tuber- 
culosis. Why not ? Because physical exercise does not 
permit continued suspension of atmospheric influence. Can 
any one assign a logical reason why tuberculosis is more 
prevalent in the. ox than in the horse? The difference lies 
in a difference of physical activity. 

All things considered, physical activity means preven- 
tion of tuberculosis. 

In these latitudes there are two conditions which com- 
pel mankind to bestir themselves, viz., poverty and riches. 

Both are blessings if rightly used. 

He who has not the wherewithal to secure the next 
meal is compelled to put forth effort either to work, beg or 
steal. 

He who has riches is compelled to care for them, or 
"they take wings and fly away." 

The effort put forth to attain these objects is physical 
activity. 

The student of history will observe the immense increase 
in wealth in this country during the past few decades. 

He will also observe this increase is largely in the hands 
of a few. 



— Hi— 

Immense wealth brings corresponding responsibility 
ofttimes not rightly used. 

Increase of poverty means increased dependence on 
those who hold the wealth. 

Ofttimes increased uneasiness or dissatisfaction that the 
difference in the social scale is so great. 

Both the rich and the poor need education and moral 
restraint. They should ever strive to be more agreeable 
one to the other. 

Legislation should never widen the chasm between 
them; the trend should rather be to close. 

These facts are noted: 

i. Increase of poverty and riches. 

2. Entailed activit}^. 

Upon whom does this activity descend ? 

The following picture presents: The rich, few; the 
many, poor; the anxious, careworn parent; the idle or vicious 
child. 

In the home of the rich — superfluit3 T , idleness, etc. 

In the home of the poor — penury, vagrancy, etc. 

What is idleness? 

What is vagrancy ? 

An answer for both — physical inactivity. 

If physical activity prevent tuberculosis, what shall we 
say of ph}^sical inactivity ? Does it not induce tuberculosis ? 

What, then, is a common cause of tuberculosis? 

Physical inactivity. 

In what way is physical inactivity a cause ? 

In that it allows suspension of atmospheric influence to 
take place in the individual. 

Suspension of atmospheric influence is tuberculosis. 

What is lacking? 

The incentive to labor. 

The rich man's child asks, "Why should I labor? 
There is no need." 

The poor man's child asks, "Why should I labor? 
There is no remuneration." 

Physicians, pastors, educators — all, teach the wort hi- 



— 142 — 

ness and necsssity of labor. It is life. 

Say some, "A woman's work is never done." 

She suffers most from tuberculosis. 

Why educate woman to labor ? 

Where does woman perform her work ? 

Usually in the ill-ventilated home. 

Does the work cause tuberculosis or is the cause of 
tuberculosis to be found directly in the ill-ventilation ? 

In every case in the ill-ventilation. 

The work as exercise is the salvation of many a woman , 

If then, the house in which we live — our home — brings 
so much disease and death, Methuselah was wise in his gen- 
eration when he said, "Why should I build me an house?"' 

Is physical culture a requisite in the education of the 
perfect man ? 

When the Rt. Hon. W. E. Gladstone m his school days 
sculled two miles up the river Thames with his college 
friend, Hallam, he was developing that physical stamina 
which served him so long and well in after years. 

His friend Hallam, in being carried, enjoyed the com- 
pany, ride and scenery, each in itself a benefit,, yet from 
these alone he received no physical brace or vitality to resist 
the inroads of disease. 

The life of the one proved a monument of achievement 
in deeds accomplished. The life of the other a monument 
of worth so soon to pass from mortal view. 

Here is a lesson to aspiring genius. Happy the one 
who clearly reads. The young man or woman who starts 
in life with a good physical and mental heritage, though 
poor in purse, should remember in these alone he has a for- 
tune. He should constantly bear in mind this fortune is in 
his hands for a purpose. That a right use of this fortune 
strengthens or increases it. A lack of use or abuse of this 
fortune diminishes it in a like proportion. These truths 
are seen on every hand. 

Two persons of equal age and import start in the race 
of life. The trysting time is now at hand. The one moves 
«©& and accomplishes the cherished object of his life. The 



—143— 

other speedily succumbs. Whence this difference? The 
one has received physical training for the race; he is pre- 
pared. The other has made no struggle and is unprepared. 

The struggle of existence is the preparation and oft- 
times determines the man. Physical training is assuredly 
necessary, let none think otherwise. 

In physical culture, what is the primary object? On 
this, as other topics, writers may differ, but the author 
takes it physical culture is for the development of the entire 
man. 

Physical culture is used in the training of certain mus- 
cles. If life be a foot-race or boxing match the training of 
certain muscles may be all that is required. But life is more 
than these. I^ife is a complex entity in which there is 
accumulation, conservation and diffusion of energy. Do not 
misunderstand. No one of these factors work alone and of 
its own free will. From infancy to manhood it is largely 
accumulation. From manhood to old age it is largely con- 
servation. It may be, or it may not be, diffusion all the 
way. 

The primary object in physical culture is to awaken, 
hold in abeyance and give forth at the proper call. In other 
words, physical training should include moral and mental 
training. He who acquires much in youth has much to 
diffuse in manhood or old age. He who dors not conserve 
the energy received has no staying power in the continued 
race, and falls by the wayside. He who best accumulates 
and conserves has most to diffuse. 

The Hie of each individual may be compared to a dy- 
namo. Electricity is developed, stored and diffused. If 
the generator be small there is little electricity to store or 
diffuse. If the storage be small there is no need to develop 
until ready to use. If the diffusion be faulty there is little 
use to develop or store. The perfect dynamo has these 
under Control. So the perfect man. Some men have strength 
— development. Some have staying power — storage. Some 
know when to give forth— diffusion. The perfect man has 
each under control.. 



- 144— 

The historical Samson had cumulation and diffusion- 
no conservation. Failure. 

The college student, Hallam, had conservation and 
diffusion — no cumulation. Failure. 

Gladstone had cumulation, conservation and diffusion. 
Success. 

Perhaps this may be illustrated in another way: Many 
cannot resist temptation — cumulation and diffusion — no 
conservation. 

Moral training or physical restraint may be necessary. 
Many, through heredity or defect, have conservation and 
diffusion, no cumulation. If due to heredity the strong arm 
of the law should assert its right for the benefit of future 
generations. 

Many have cumulation and conservation, no diffusion. 
Among this number are the multi-millionaires in health and 
strength, who acquire and hold but never give. Lazy lumps ! 
What a shame ! 

The primary object of physical culture should be to 
render the circuit complete and under control, 

Should physical culture be alike for all ? 

As anatomy tells us the human body at all times has 
essentially the same number of muscles, so one naturally 
infers if one muscle needs training, then all. As the rela- 
tive strength of these muscles varies with the individual, so 
one naturally infers the exercise should be adapted to indi- 
vidual capacity. The rule should be: No muscle to lie idle, 
no muscle to be exercised above a healthy endurance. 

Ought physical culture or training be continuous ? 

The Christian might ask y ought prayer be continuous, 
meaning ought the believer to pray once, twice or three 
times per day during life. The answer would be, "Pray 
without ceasing." Meaning that at stated intervals the 
Christian should hold communion with God. The fre- 
quency of these intervals must be determined by the needs 
of the soul. So in physical training. The needs of one's 
system must determine the frequency or duration of exer- 
cise. In eating, one partakes of food wheu he is hungry. 



— 145— 

The frequency of eating or amount of food must be deter- 
mined by the needs of the system. Some people do not eat 
enough; they starve the body at the expense of the intellect. 
Others eat too much, so much, indeed, they scarcely know 
the}' have an intellect. 

With prayer and physical exercise the average man is 
not apt to overdo. Yet it must be admitted with the physi- 
cal wage earner there are many, many times when the sys- 
tem becomes exhausted. This should not be. The wage 
earner should have his periods of work and repose as others. 
The brain worker should take a certain amount of physical 
exercise each da}', preferably in the open air, the amount to 
accord with the physical make-up of the system. If the 
quantity of food ingested be large the exercise should be 
more active or prolonged. If small, then less so. The 
brain worker will hold out longer and accomplish more by 
observing this simple rule. Work or physical exercise is 
intended for all. There is no exception to it on this earth. 

To briefly resume: All should engage in continuous 
physical culture for perfect development. 

What does perfect development bring ? Freedom from 
tuberculosis. 

Ought promiscuous spitting to be stopped ? 

Under a repub lican form of government all its people 
are free and equal. 

Equal in that each has certain inalienable rights which 
cannot be abrogated. 

Free in that each does as he please, provided he does 
not displease his neighbor. 

As a people we are a nation of spitters. This arises 
from two causes: The use of tobacco and the prevalence of 
catarrh. 

For the habitual user of tobacco, the writer has little 
sympathy. For the sufferer from catarrh he has great 
regard . 

"Cleanliness is akin to godliness." 

All tobacco users are filthy. It is impossible for them 
to be otherwise. While there are grades of filthiness, from 



— 146 — 

the esthetic smoker, whose breath at times emits perfume, 
to the mendacious chewer and spitt er, who wallows in saliva, 
all are filthy. 

"Let him which is filthy be filthy still." 

In one who suffers from climatic influence, or a consti- 
tutional dyscrasia, the case is different. He, too, may be 
filthy, yet ofttimes it is not a filthiness from choice. The 
filthiness is thrust upon him. 

We are a nation of spitters. 

Let him who thinks otherwise enter the crowded church 
or hall and examine. Let him move through the crowd 
around the central stove of eating house or saloon, or glance 
into the cuspidors of the more modern hotel. This, we 
think, will convince. 

Ought promiscuous spitting to be stopped ? 

In attempting to answer this question there are two 
things to be considered. 

(a) Is spitting beneficial to the one so inclined? 

(b) Is spitting injurious to the neighbor ? 

On the answer given these questions must hinge the 
oughtness of promiscuous non-spitting. 

No tobacco user can swallow his saliva continuously. 
He must, in some way, eject it. Spitting, then, in his case, 
is beneficial to himself. If it be shown spitting is injurious 
to the neighbor, the oughtness of it should be considered, 
for no one in health is compelled to use the weed. Its use 
is simply a habit. To the neighbor who wears long dresses 
and asks, "Why should I be compelled to endure the nui- 
sance of spitting ?" the user of tobacco may reply, "Why 
should I be compelled to endure the nuisance of trains ?" 

The one is as much a nuisance as the other. 

Should one who views life from a practical or esthetic 
stand-point ask the same question, no such reply could be 
given. 

The way, then, is plainly open to the tobacco fiend.. 
To at once stop its use or care for his saliva. 

On this subject the common law and the law of eti- 
quette should be plain and harmonious.. 



—147— 

There ought to be no mistake. 

Having considered the status of the tobacco user, let us 
now consider the rights of the afflicted. His rights, it 
seems to the writer, have been flagrantly violated in all dis- 
cussion of the past. At the outset, it may be asked, what 
right has the afflicted that may not be granted to the healthy ? 
If the healthy have no right to spit on the floor or carpet, 
in the hall or home, why should this right be accorded to 
the sick ? Let us be candid. 

No such right is granted. 

Whether in sickness or in health no man or woman can 
claim the privilege of indiscriminately spitting. 

It is a nauseating and filthy habit and should be so re- 
garded by all intelligent people. 

At the same time there are extenuating circumstances. 

It is to these we would, at present, direct attention. 

i. The patient is suffering from climatic influence. 
He has recently taken cold, or has an influenza. He must 
needs cough and hawk and spit. The patient and his 
neighbor must bear these patiently. What we cannot amend 
we must endure. But please observe in every case it is the 
plain duty of the patient to care for his sputa. He has no 
right to place this sputa in any way to inconvenience his 
neighbor. If so placed, his neighbor has the right to object. 
This much for the ordinary cold. 

2. The patient is the subject of a constitutional dys- 
crasia. The dyscrasia is a something, not of the patient's 
volition. Perhaps it is due to marriage, or manner of life 
of his ancestry — a thing beyond his control. It is the pa- 
tient's duty, so far as in him lies, to ameliorate or remove 
this dyscrasia. It is his duty to care for his sputa. Is this 
all ? Has the public no duty to perform ? While the pub- 
lic is asking so much of the patient, from a mere esthetic 
point of view, ought not the public to discharge its plain 
duty in securing a more healthy generation in the years to 
come ? Why should the public demand so much of the in- 
dividual, while it accords so little to the individual in return ? 

3. The patient has tuberculosis. Laying aside, for 



the moment, the cause of tuberculosis— whether the germ 
tubercle bacillus, or suspension of atmospheric influence- 
laying aside the contagiousness of tuberculosis — whether all 
or none in health take the disease — ought promiscuous spit- 
ting to be stopped ? Yes, from an esthetic stand-point. 

Assuming tuberculosis is due to the germ tubercle ba- 
cillus, ought promiscuous spitting be discontinued from this 
stand-point alone ? No. Tubercle bacilli are found in every 
atmosphere. If the direct cause of tuberculosis, all would 
have the disease regardless of sputa. 

Assuming suspension of atmospheric influence to be 
the primary cause of tuberculosis — that no tuberculosis 
exists without first having this condition or precedent state 
— ought promiscuous spitting be stopped? No. If sus- 
pension of atmospheric influence must be present before 
tuberculosis can exist — if the ventilation be perfect — what 
matters it whether there be one or one thousand tubercle 
bacilli per cubic foot of air space ? 

In the contagiousness of tuberculosis the writer is in- 
sistent. There must first be the precedent state before one 
can take the disease. 

It is not the number of tubercle bacilli in the air, but 
the presence or absence of the precedent state that deter- 
mines the contagiousness of tuberculosis. 

When one insists that all sputa should be burned or 
destroyed, from an esthetic stand-point, he is consistent 
with the facts in the case. 

When one demands destruction of sputa on the ground 
of its becoming dried and mingled in the air, and thereby a 
source of contagion to the healthy, he is asserting that 
which the facts in the case do not justify, that which he 
cannot maintain. 

What leads to a belief there is other cause of tubercu- 
losis than the germ tubercle bacillus ? The fact that only a 
portion of human kind take the disease. If the tubercle 
bacillus be the direct cause of tuberculosis, all should take 
the disease, for all are exposed. 

What other reasons can be assigned ? The tubercle 



—149— 

bacillus is not found growing in the healthy individual. If 
the direct cause, the growing bacillus would be found in 
health. 

Is there other reason to confirm this belief ? A period 
of indisposition on the part of the patient, always precedes 
the entrance of the growing bacillus. If the bacillus be 
the direct cause, this period would be superfluous. 

In what way can we determine the presence or absence 
of this period ? By clinical observation and history. 

In what way is this period of indisposition naturally 
produced ? By suspension of atmospheric influence. 

Can we induce an artificial indisposition which will 
allow the living tubercle bacillus to enter one's system and 
take root; if so, in what w T ay? By suspension of atmos- 
pheric influence. 

If one has this natural or acquired indisposition, or 
precedent state, in what way can he rid his system of its 
baleful influence ? By physical exercise in the open air. 
The air is necessary, in that it supplies a long felt need in 
oxygen restored. The exercise is necessary, in that it ex- 
pands and contracts the lungs, thereby forcing the air into 
the remotest cells. 

Is, then, the open air treatment of tuberculosis cura- 
tive? In every case, in the first stage of the disease, i. e., 
before the tubercle bacilli take root. 

Is this truth an important one? The most important 
in the history of the disease. A knowledge of this truth 
and its practical application would revolutionize treatment 
and control the disease — tuberculosis. A truth of such 
magnitude is w v orthy consideration. This truth is formu- 
lated in the law of tuberculosis. 

If, then, we rightly understand the writer, is the oxy- 
gen treatment of tuberculosis beneficial? It is beneficial, 
more especially in the first stage of the disease, i. e., before 
the entrance of the tubercle bacilli. 

Is the oxygen treatment curative? It is never curative 
in that it does not remove the first cause of the disease, viz., 
suspension of atmospheric influence. The treatment re- 



-ISO- 
stores oxygen, ad interim, and thereby temporarily builds 
up the system. The cause of the disease, being constantly 
at work, gradually undermines the system and results in 
the death of the patient. Oxygen treatment alone does not 
cure tuberculosis. 

You have spoken of the open air treatment. In what 
way is this treatment curative ? The living tubercle bacil- 
lus cannot enter one's system and grow unless there first be 
the precedent state. The open air treatment is curative in 
the first stage of the disease in that it drives awa3^ the pre- 
cedent state and thus prevents the entrance of the tubercle 
bacillus. With an hereditary taint this treatment must be 
continuous in order to prevent the disease. Herein is shown 
the ill influence, in treatment, of the tubercular dyscrasia. 
An universal marriage law and correct living are the only 
two metheds that will thoroughly eliminate this dyscrasia. 

We have hospitals in this and other countries in which 
the cure of tuberculosis, in all its stages, by the open air 
treatment, is announced; are these statements reliable? It 
is a sad commentary on human nature that statistics, like 
many other things, are modified by the "almighty dollar." 
But such is the truth. We have professors wdio are utter- 
ing half truths in statistics year after year; men who have 
not the vital stamina to tell what they truly know. While 
we must recognize a difference between the teacher and the 
thinker, at the same time please reflect — w r e are teaching a 
future generation. Men and women are rearing an edifice 
of knowledge that in future use will be cumbrous machin- 
ery. So in the statistics we gather; many of these are 
senseless verbiage. To return: Tuberculosis is caused by 
suspension of atmospheric influence. To restore this influ- 
ence would restore the patient to health, provided there be 
no destruction of tissue, etc. There are in nearly all hos- 
pitals tubercular patients with destruction of tissue, etc.; 
therefore, but few of these p atients are restored to health. 
Let us illustrate: Mr. A runs a circular saw; in its use he 
loses a hand; can any hospital restore that hand as before ? 
Mr. B has tuberculosis; cavities are discovered in his lungs; 



—151 — 

can any hospital fill those cavities with normal lung tissue ? 
The age of miracles is past. Why attempt to show the 
present age a miraculous one? The age is not miraculous. 
The attempt, if made, is simply a shield in order to more 
effectually grasp the mighty dollar. Let us be honest. 

In general terms, does the open air treatment benefit 
tuberculosis ? Yes, in many ways (our own classification is 
used.) In the first stage, as already shown, this treatment 
is curative. In other words, tuberculosis is under control 
in the healthy subject. In the diseased subject, as in hered- 
ity, or in the second cr third stage of tuberculosis, it is dif- 
ferent. In heredity, a soil is alread}- prepared; if the con- 
ditions of life be favorable, the bacillus at once takes root; 
not so in perfect health; a condition of life maybe favorable 
to the growth of tubercle bacilli, and yet they do not grow. 
Why ? Absence of the precedent state. Again, in the 
tubercular dyscrasia as inherited, there must be a constant 
battle to hold the condition of the system at the normal; not 
so in perfect health. Man}' flagrant violations of law may 
occur, and yet recovery is possible. Is the force of heredity 
seen ? 

In the second and third stages of the disease the pre- 
cedent state is of necessity present. There are present the 
growing bacilli, and, in many cases, abscess cavities. It 
has been shown that the open air treatment cannot restore 
lost tissue; lung tissue, broken down, has disappeared for- 
ever. What can the open air treatment do in these cases ? 
Prolong life and afford a small chance of recovery. In all 
these cases there is still left a small amount of working lung 
tissue. By the open air treatment this small amount of tis- 
sue is placed at its best; by its proper use, with no incum- 
brance other than the growing bacilli, the patient is kept in 
better condition and life is prolonged. Constitutional treat- 
ment in connection affords the best results. A good family 
history with, open air and constitutional treatment will re- 
store a share of these cases to health, and in every case will 
prolong life. In truth, this treatment is the best known to 
the science of man. At the same time it must ever be re- 



-152 — 

membered prevention is the great field in which to labor. 
Tuberculosis can be controlled. 

Cannot exception be taken to the language used in 
speaking of treatment? To the followers of Koch, perhaps, 
TR will rank first; to those having hospitals at command, 
other systems will continue in vogue. To the, one who 
carefully examines causes and effects, the writer thinks 
there is but one answer: The open air treatment is the most 
potent, if not the only reliable therapeutic agent. The 
writer has seen consumption recover under open air treat- 
ment without the administration of any drug whatever. 

On what is this answer based ? Careful observation — 
to the readers who have carefully observed the old-time 
homeopathist, of triturations and dilutions, you have seen 
one thing: The great care used in selecting and arranging 
the patient's room; the largest room, the one with the most 
sunlight and best ventilation is the one chosen. The 
homeopathist succeeds in the treatment of tuberculosis 
where the regular has failed. Why ? Certainly not on 
account of the medicine given, for flies sip copiously, night 
and day, from the dilutions without apparent effect. Why 
the benefit? On account of the oper> air treatment. 

Is tuberculosis contagious? 

This question is often asked by near relatives, friends 
and attendants; those who directly minister to the wants of 
the patient. As a question, it is a perfectly proper one and 
should be answered in all sincerity. 

Before directly attempting an answer, perhaps a pre- 
liminary statement is necessary. 

Among civilized nations, tuberculosis is found in nearly 
every locality, is fatal in its nature, and is by some thought 
to be on the increase. Since the advent of the germ theory 
of the disease many worthy people have held tuberculosis 
should be isolated as variola, etc., on account of its contag- 
ious nature. These people have even invoked the aid of law 
to prevent contagion — to protect the healthy. 

Is tuberculosis contagious ? 

The word contagious is used in its ordinary sense. By, 



—153— 

is a disease contagious, is meant, is a disease catching ? 

Can one take the disease from another while staying in 
his house or rOom as nurse, or doing the ordinary work of 
the household ? In other words, does one ordinarily take 
tuberculosis while pursuing these vocations ? 

Is tuberculosis contagious ? 

John Smith is twenty-seven years of age , has a loving 
wife with five small children and the disease tuberculosis. 
No insurance. Mrs. John Smith is twenty-five years of 
age, of nervous temperament; does the work of the house 
but has heard of the germ tubercle bacillus. Mrs. S. thinks 
dearly of John, but occasionally thinks of herself and fam- 
ily. Very natural. She consults her family physician, 
who is a germ theorist. 

''Doctor, I am afraid of catching this disease. Is tub- 
culosis contagious?" 

"Madam, your question is a very timely and pertinent 
one. I have been in attendance on your husband now for 
about one month. There is no question whatever as to the 
nature of his disease. Had thought several times of telling 
you to be more careful, but I have been busy, extremely 
busy. . Mrs. S., you ought not to enter your husband's 
room. There is great danger of the tubercle bacilli enter- 
ing your system." 

"But, doctor, what shall I do ?" 

"You ought to hire a nurse at once. A competent and 
thoroughly trained nurse; one who clearly understands the 
situation." 

"But, doctor, how shall I pay him?" 

"Really, madam, I do not know. The law makes no 
provision." 

"Doctor, will the nurse not take the disease ? If the 
bacilli enter my system, will they not enter the system of 
the nurse as well ?" 

"Madam, you do not understand. The nurse will take 
proper precautions." 

"Well, doctor, can you not give these precautions to 
me ? Why hire a nurse?" 



- 154— 

"You have thus far discharged the duties of nurse. 
Your work has been done well, yet there are certain precau- 
tions that should be observed. All sputa should be burned. 
The object in this is two-fold: To prevent contagion on the 
part of attendants and to prevent reinoculation on the part 
of the patient." . » 

"Doctor, since my husband's sickness I have burned all 
sputa, as an act of cleanliness. ' ' 

"As I said before, you must not enter your husband's 
room. There is great danger." 

"Doctor, in what does the danger consist ?" 

"What a question ! In what does the danger consist? 
The air is full of living tubercle bacilli. The danger con- 
sists in these bacilli entering the system and causing tuber- 
culosis." 

"But, doctor, does not all air contain tubercle bacilli ? 
Why should I be denied entrance to my husband's room?" 

"True, the tubercle bacilli are ubiquitous, but they are 
not so plentiful elsewhere as in your husband's room." 

"Doctor, how many tubercle bacilli does it take to start 
tuberculosis ?" 

"Well, really I do not know, but I suppose one or two 
would be all that is necessary." 

"Doctor, I have read there are many microphytes in 
the ordinary atmosphere. Now, according to your theory, 
in order to prevent tuberculosis, one would have to stop 
breathing." 

"Madam, there are so many things you must learn from 
experience. As I said before, you ought not to enter your 
husband' s room. ' ' 

"But, doctor, how shall I attend to his wants?" 

"By means of a telephone. So far as I know, no ba- 
cilli travel by wire." 

"Doctor, shall I convey his food and clean linen and 
arrange his bed by telephone ?" 

"Certainly, madam, certainly." 

"Doctor, ought. I to wear deceptive gloves while mak- 
ing my husband's bed?" 



—155— 

" Deceptive? You mean aseptic. There are so many 
mistaken terms in science." 

"Doctor, you say my husband's room is improper in 
that it contains multitudes of tubercle bacilli. What would 
you say to a larger room with more perfect ventilation ?" 

' 'Madam, this is not in accord with approved treatment." 

"But, doctor, would not a larger room with perfect 
ventilation lessen the number of tubercle bacilli per cubic 
foot of air space ? Would it not render the room more fit 
for a nurse to enter ?' ' 

"Robert Koch, the greatest scientist who ever lived, 
does not treat tuberculosis in that way. He huddles his 
patients in small rooms. This is approved treatment." (Dr. 
Hyndman, Cincinnati, O., speaks of the number of patients 
in a small room.) — Lancet Clinic in Koch's hospital. 

"It seems to me, doctor, that science could yet learn a 
little common sense. However, so long as you are attend- 
ing physician, I will obey orders." 

"On one condition, madam, I will allow you to enter 
your husband's room: Provided you wear a mask well 
padded with cotton wool. The wool strains out the tuber- 
cle bacilli." 

"Yes, doctor; thank you. I can then look at my dear 
husband." 

"Yes, madam; but you must refrain from speaking." 

"In regard to diet, madam, it matters little what you 
give your husband to eat, provided it be served in the proper 
manner." 

"Doctor, what do you mean by proper service?" 

"All food contains tubercle bacilli. The food and 
dishes should be perfectly clean and all milk sterilized and 
the dishes placed in the hot oven before and after use." 

"Doctor, do you allow butter to your patients?" 

"Butter in limitations is quite nourishing. It is used 
with the usual precautions." 

"What do you consider the best way to sterilize butter?' ' 

"Butter should be boiled. It is best eaten while hot 
through a sterilized tube. There is then no danger of in- 
fection." 



- 156- 

"Doctor, what shall I do in regard to my five dear 
children?" 

"Madam, I have not read the latest article by Count 
Von Blaunerhasselt, but I am of the opinion you ought to 
take unusual precautions." 

"Doctor, what would you think of sending them to their 
grandfather's? He lives on a farm far in the country. 
The children could have abundance of exercise in the open 
air and plenty of nourishing food." 

"Madam, if you value their lives as anything at all, 
you should do no such thing. To insure safety, your 
children should be placed in a germ-proof house and the T. 
R. treatment commenced at once." 

"Doctor, of course I have a mother's fear, but is the 
T. R. treatment dangerous?" 

"The danger from the T. R. treatment is now at a 
minimum, but of course in all cases there is danger." 

"Doctor, what is the object of T. R. treatment ?" 

"The primary object is to induce immunity." 

"May I ask one other question, doctor? What is 
meant by immunity ?" 

"There are two forms of immunity, madam. Immun- 
ity to tuberculosis and immunity to tubercle bacilli. It is 
of the former kind I now speak." 

"Doctor, do you mean by immunity to disease that one 
has the disease all the time ?" 

"No, madam; the very opposite. When one has im- 
munity to disease he never has the disease; he never has 
the disease so long as he is immune." 

"How long does immunity last, doctor?" 

"That depends. On an average something more than 
two hours." 

"Well, doctor, of course I am a woman, but this does 
not seem like immunity to disease, but rather a continuation 
of immunity." 

"As I was about to remark,, there is another form of 
immunity, viz., immunity to the tubercle bacillus. If one 
should be so immune that the germ could not enter his sys- 



—157— 

tern and grow, as this germ causes tuberculosis, the person 
so immune could not take the disease if he desired to do so." 

"Doctor, that is just the immunity I desire for my dear 
children; please explain." 

1 'Virulent living tubercle bacilli are injected into healthy 
guinea pigs." 

"Doctor, you do not mean to so inject my children, do 
you?" 

"If left alone, in every case, these guinea pigs die of 
tuberculosis. ' i 

"Doctor, my children are not guinea pigs." 

"If these guinea pigs are injected with T. R. in time, 
the animals do not die of tuberculosis." 

"Doctor, you stated the guinea pigs are healthy. Why 
have them die at all?" 

1 'As I said before, the germs of disease must be injected. ' ' 

"Doctor, as I said before, I am a woman. If my babe 
takes tuberculosis, are the germs of disease injected? Does 
not a condition of system allow the tubercle bacilli to 
enter? Does the T. R. treatment or injection eliminate the 
condition of system ? If not, does it or can it cure the dis- 
ease tuberculosis ? Doctor, please answer my question: Is 
there not always a condition of system that precedes the 
natural entrance of the growing tubercle bacillus ? If yes, 
theT. R. treatment cannot cure tuberculosis." 

Is tuberculosis contagious ? 

Yes, if you have the precedent state. 

No, if you have it not* 



-158- 



AN OUTLOOK. 



To one who travels the northern portion of our country 
and sees the boulders scattered here and there — some large, 
some small, all rounded as if by gradual attrition and con- 
tinuous movement — he is led to inquire, whence came these 
and what cause can be assigned ? It was the observation of 
these and similar data that led to the glacial theory, now 
generally adopted by scientific men. But what caused gla- 
ciers in this latitude? Evidently, it was change in climate, 
but in the attempt to explain this man is baffled at every 
step. 

Thus it often is in the elaboration of any theory. In 
science as in religion we see through a glass darkly, and yet 
we see. To the physician who has sat by the bedside and 
ministered to the wants of his patient in the dread disease 
tuberculosis, and witnessed a decline more apparent day by 
day, though steadily laboring to combat symptoms, he is 
led to inquire, why this dark blot on present civilization and 
just stigma to medical science? 

It is this and similar observations which has led to var- 
ious theories of the disease. One sees symptoms in tuber- 
culosis which are distinctly nervous, and he declares it a 
disease of the nervous system. Another, as he travels, be- 
holds germs or vegetable growths in all tuberculous tissue; 
to him these cause the disease; he at once formulates and 
advocates the germ theory. 

The writer plainly asserts he is not satisfied with either 
theory. Perhaps it is because he has one peculiar to him- 
self. Some people are built in this way. They are satis- 
fied with nothing unless it conforms to their ideas. Be this 
as it may, the writer gives his theory gratis, and the rea- 
sons are accompanied therewith. What more can be asked ? 
We speak plainly, it is not our purpose to unjustly judge 



—159— 

any theory, but to give as best we may our reasons for dis- 
carding the same. In doing this we do not arrogate all 
knowledge to ourselves, but we speak in order to be clearly 
understood* 

If the disease tuberculosis be of nervous origin on ac- 
count of the nervous symptoms, why not in the same breath 
declare it of muscular origin on account of the muscle wast- 
ing seen in every case ? It seems to the writer this would 
be just as consistent. One thing medical men should know: 
An attendant symptom is not necessarily a cause of disease. 
Every disease has symptoms peculiar to itself. Symptoms 
correctly observed render the diagnosis clear. But watch- 
ing symptoms is not determining the cause of disease. 

If germs alone truly cause tuberculosis, if the germ be 
ubiquitous, as most writers claim, why do not all take the 
disease ? Why do any escape ? If true, the result is mar- 
velous in the extreme. Herein is the greatest fallacy of 
the century. 

It is assumed that the plant tubercle bacillus is a parasite. 
It is a -parasite only in the sense of its growing on an an- 
imal already diseased. It never grows on the healthy 
animal. This was pointed out many years ago and has not 
been successfully refuted. Where are our living germ 
theorists ? Living germs are abundant. 

One thing must be evident to every unbiased mind: A 
plant cannot grow without a proper soil. Whence comes the 
soil ? The germ theorist assumes the tubercle bacillus grows 
indifferently in any soil. The writer thinks this is no such 
thing. In every case the soil must be -prepared. Ofttimes 
no doubt it is prepared unwittingly, but preparation, as the 
seed, alike is requisite. This all must learn. 

In many ways the soil is analogous to the soil of the 
farm or garden. As is well known, all soils are not alike 
productive. Some must be rendered fertile,- some need great 
care in preparation; some are but waiting for the seed. 
Each soil needs its particular care or attention. This the 
wise farmer learns from sad experience. So, in tuberculosis 
<as with greatness, some are born great, some achieve great- 



— i6o— 

ness and some have greatness thrust upon them. Some in- 
herit a soil, some acquire a soil and some have a soil thrust 
upon them. In tuberculosis this may seem strange, start- 
ling and discordant, yet it is nevertheless true. It is the 
discordant note in this disease that renders the harmony 
more complete. 

My attention was early called to law in tuberculosis. 
What is meant by law ? Plainly speaking, law is uniform- 
ity of action. Wherever uniformity of action is seen there 
must be law. Examples: A drop of water undisturbed 
assumes a globular form — law; the moon revolves around 
the earth, and the earth around the sun in regular periods 
of time— law. In the higher mathematics should we dem- 
onstrate that planets pass over equal areas in equal times we 
prove a law. Law is an order of sequence. Should the 
same thing occur year after year without variation, this is 
law. My office rent is due every six months. This is the 
law of the firm. Of this we are conscious. The physician 
should adopt just such a law, only made monthly, some 
think weekly. 

Laws may be divided or classified as known or un- 
known. Known laws are accepted without question, or 
should they be questioned, may be verified. Unknown laws 
are discovered like planets, and after discovery may be seen 
by those having eyes or intellect. "Seeing is believing." 
They then become known laws. 

A word in this connection: To the average mortal 
mathematics is dry and uninteresting. The writer has a 
fondness for this particular study. At college in this branch 
he was excelled by none. Some think mathematics of little 
value. A distinguished language professor said to his class 
this year: "All we need of mathematics is to be able to 
break a five dollar bill properly and receive the correct 
change." Is this true ? Would it not be nearer correct to 
speak of language on this wise ? "All we need of language 
is to be master of our own." But we confine our remarks 
to men writing for the medical profession alone. Allison 
Drake on "Twentieth Century Medicine a Liberal Educa- 



— i6i— 

tion," in the Colorado Medical Journal, speaks of "the leger- 
demain of algebra," and "the incapacity of professional 
mathematicians for dealing with problems of mixed uncer- 
tainties as notorious." 

The writer thinks if we are truly dealing w ith problems 
of mixed uncertainties, the legerdemain of algebra is just in 
place. But where do we find such problems ? In that book 
of formulas known as analytical geometry, which requires a 
knowledge of algebra, geometry and trigonometry; no leg- 
erdemain or mixed uncertainties are found. Remember, 
these formulas are used in calculations, as calculus, etc., 
which are very accurate. "Be not deceived." True, some 
professionals are so merged in their calling they know little 
else; this, however, is just as true of musicians, mechanics, 
etc., as of mathematicians. Let no sane man decry the 
accuracy of mathematics. Mathematics alone is the exact 
science. 

The truth of the matter appears to be this: Whatever 
trains the mind to comprehend clearly and reason accurately 
should be used in the preparatory education of the physi- 
cian. Mathematics in the training of the reason is trans- 
cendent; at the same time he who is most familiar with 
other languages is most master of his own. In medicine 
one should alike be master of language and reason. 

We said our attention was early called to law in tuber- 
culosis. We also said we are extremely fond of mathemat- 
ics. In conning the authorities we find no one dies of 
tuberculosis in the frigid zone. Why ? Do they all freeze ? 
No one lives there? Please let this pass at present. We 
are seeking law. 

We put down at once what is given by standard medi- 
cal authorities. It reads as follows: 

TUBERCULOSIS. 

Zone. Death-rate. 

Frigid o 

Torrid ^ Small 

Temperate Great 

We then seek reasons for the above and in so doing 



— l62 — 

liberally consult the authorities. It excites one's risibility 
to think of some of the reasons given. Take the frigid 
zone in illustration. One author finds as a reason for the 
zero death-rate in this zone that the people eat a vast amount 
of fat meat. Hence, the remedy in any climate — cod-liver 
oil, glycerine, cream, etc. Just reflect one moment. More 
fat is eaten per capita in the temperate zone than in the tor- 
rid zone, yet the death-rate is larger; so that in giving this 
reason there is neither law nor common sense. 

Another, a germ theorist, finds the reason very simple, 
The climate is so cold the tubercle bacillus is frozen. Hence 
the remedy is to cook the bacillus in situ and cure the dis-* 
ease in any climate. The writer passes this man by by 
calling him a very si?nfle reasoner. 

After long consultation and many sleepless nights we 
found a something that fills the vacancy. My readers have 
probably heard of it before, viz., suspension of atmospheric 
influence. We now fill this vacancy and ask all readers to 
look: 

TUBERCULOSIS, 

Zone, Death-rate. Suspension. Ratio-. 

Frigid ........ o o i 

Torrid .Small Small ,, i 

Temperate . . . .Great Great i 

Please notice the regularity. Webster says whenever a 
regularity is traced, law must exist. A law is formulated. 
In tuberculosis the ratio between death-rate and suspension 
of atmospheric influence is always constant. We prefer the 
following construction: The death-rate from tuberculosis is 
in direct ratio to suspension of atmospheric influence. Take 
your choice:, they are the same. L,et us see if this law 
holds good in its practical application. "The proof of a 
pudding is in the eating.''' 

The first column, under death-rate, is standard author- 
ity, and, so far as the writer knows, has never been called in 
question. The second,, under suspension, is our own, and, 
of course, is debatable, L,et us see — no suspension in the 
frigid zone. How da you- make this appear ? The houses 



-i6 3 - 

or huts are made of snow or ice. Suspension in such huts 
is an impossibility. In snow the interstices are filled with 
air and where there is an abundance of air there can be no 
suspension; ditto in ice, though not so great. The dry at- 
mosphere of a cold climate keeps this air contained in these 
meshes or interstices in constant circulation. Writers who 
have lived in this zone tell us under these circumstances it 
is impossible for one to take cold. Taking cold, 'I appre- 
hend, is not clearly understood. 

How about small or little suspension in the torrid 
zone ? With few exceptions the life is wholly in the open air. 
The climate is hot and arid as a whole and permits or allows 
this. Were the inhabitants of this zone as cleanly, and, in 
fact, as civilized as in the temperate zone, the writer sees 
little reason why tuberculosis could not be eliminated entire. 

What reason is assigned for the great death-rate in the 
temperate zone ? In this zone the reasons are multifarious. 
Our life, for the major part, is an in-door life, i. e., is in in- 
closed buildings; these are ofttimes but illy- ventilated. Life 
in the open, at best, is only for. a few days in the year. 
While the fathers and sons live for the greater part in the 
home, the mothers and daughters live almost exclusively in 
the home. Vast numbers live in the shops and factories; 
these are poorly ventilated and filled with dust and smoke. 
This dust and smoke in the lungs prevents a perfect aera- 
tion. Add to this the consumption of gas or fuel which ab- 
stracts oxygen. These factors are constantly at work, viz. , 
indoor life, impurities in the air, lessened amount of oxy- 
gen. Remember, also, such factors as these: Thickened 
lung tissue from changeable temperature, etc.; heredity, in 
that there is deficient lung tissue, capacity, etc.; heedless- 
ness, in that there is ignorance of the true cause of disease. 
Hence, the great death-rate is caused by great suspension of 
atmospheric influence. 

In December, 1890, the author published an article in 
the Cleveland Medical Gazette, in which occurs the follow- 
ing: "Nature controls tuberculosis beyond the polar circles ; 
nature controls in great measure tuberculosis within the 



— 164 — 

tropics. Nature is doing all she can for us. Can we help 
her? I believe we can; that the day is not distant when 
tuberculosis will be banished from our midst." 

A law is given in tuberculosis — as we prefer to call it, 
the law of tuberculosis. The writer is aware this law is an 
innovation. In medicine, as in kindred sciences, innova- 
tions arise. We trust this one will lead to a more clear 
comprehension of this most deadly disease. To the author 
it is not distinctly new. Fourteen years ago it was written 
on a blackboard and presented to the Portage County Medi- 
cal Society. Some of the members of said society are yet 
living; others have passed to the great beyond. The law is 
presented in all sincerity. The writer knows whereof he 
speaks. He is assured. 

Notice the working of this law as seen in animate na- 
ture around us. No wild animal has tuberculosis. Why ? 
No suspension of atmospheric influence. Domestic animals 
have tuberculosis. Why ? Suspension of atmospheric in- 
fluence. Of animals dying of this disease which have the 
greatest proportional fatality ? Those having the greatest 
suspension. Which the least fatality? Those having the 
least suspension. 

Again, in treatment. What remedy is of most avail in 
any stage of the disease ? A life in the open air — removal 
of suspension. What can be said of incurable cases ? 
The suspension cannot be removed. 

Notice the law: The recovery in tuberculosis is in direct 
ratio to removal of suspension. 



-165- 



VAOARIES. 



" 'But,' I sez, 'can you tell how the little seed of this 
weed goes down into the earth and selects just what she 
wants out of the great store-house below ? She never comes 
out in a pink head-dress or a yellow gown. No, she always 
selects what will make the blue. It shows that it has life, 
intelligence, or else it couldn't think, way down under the 
ground, and grope in the dark, but always gropin' just 
right, always a thinkin' the right thing, never, never in the 
hundreds and thousands of years makin' a mistake. Why, 
you couldn't do it, Josiah Allen, nor I couldn't. And we 
set and see these silent mysteries a goin' on right at our 
door-step, day by day and year by year, and think nothin' 
of it, because it is so common. But if anything else, some 
new law, some new wonder we don't understand comes in 
our way, we are ready to reject it and say it is a lie.' " — 
(Samantha at Saratoga.) 

The advent of the germ theory of tuberculosis brought 
with it many vagaries. Some of these have become obselete, 
while others are more modern — the old and the new. 

The endeavor is made at this time to point out a few of 
these whimsical notions, wild fancies or extravagant ideas. 
The object is to touch upon nothing that has distinct merit 
-per se without giving the same due credit. 

Foremost among these vagaries is, perhaps, the notion the 
plant tubercle bacillus is a bug, its extract a veritable bug- 
juice. Who first gave loose rein to his imagination in this 
regard is unknown. Whether he spoke of verities or un- 
certainties is unknown. Certain it is, some editors and. 
many writers still cherish these ideas. Associations linger. 

The tubercle bacillus is not a bug, but is a plant, deriv- 
ing its nourishment from the soil. As all vegetation re- 



— 166 — 

quires a soil, so likewise the tubercle bacillus. 

Perhaps this may be best expressed in postulates: 

i. No vegetation can grow without a soil. 

2, The soil must be peculiarly adapted to the plant. 

Of the first, no question will be raised; it is self-evi- 
dent. Of the second, it is known that certain soils are 
adapted to certain plants; other soils will not raise them. 
The wise planter selects the soil by direct observation or 
experiment; otherwise he meets many failures. 

A second vagary is, the tubercle bacillus will grow in- 
differently in any soil; in other words, as parasites are found 
indifferently on sickly and healthy animals, so likewise the 
tubercle bacilli. The outgrowth of this second vagary is 
due to the common belief that the tubercle bacillus is a 
parasite. It is a parasite in the sense that it is found grow- 
ing in 'the living animal; it is not a parasite in the sense 
that it is found growing in all animals, regardless of their 
condition. No tubercle bacilli are found growing in 
healthy animals. A manifest distinction is here made. If 
then, the tubercle bacillus be a parasite, it is a -parasite of 
disease and the disease takes -precedence. 

From observation the tubercle bacillus is found grow- 
ing in a soil prepared by suspension of atmospheric influ- 
ence. It naturally grows in no other. 

By experiment a soil may be so prepared and the plant at 
once takes root. Hence,, we conclude there is a law of 
vegetable growth for this particular plant. As the seed of 
this plant is everywhere present, as the soil is in various 
stages of cultivation or preparation, so tuberculosis is seen 
in various stages of development. 

One who takes into consideration only the plant, re- 
gardless of the soil, is like the farmer who cares only for the 
seed. From him the soil receives no attention. To this 
farmer a small or large crop is equally satisfactory. The 
ordinary farmer is not so constituted. So we think one 
should take into consideration the condition of the animal 
as well as the plant. Certain it is, unless the soil be correct.. 



— 167 — 

there will be no growth. 

Vagary three: The tubercle bacillus is dangerous. An 
early experience in hospitals where operations were per- 
formed under a continuous spray, a later experience where 
patient and instrument were injured by so-called germicides. 
a still later where no care was taken except cleanliness, 
makes us somewhat sceptical of injurious germs. But, as 
the heading shows, we confine our remarks to this particu- 
lar germ, and assert, if the reasoning thus far be correct, 
no tubercle bacillus can be dangerous unless the subject of 
injection have a favorable soil. The observation and rea- 
soning along this line has been somewhat curious: 

(a) Historical. — Many observers of the past have re_ 
garded tuberculosis as infectious or contagious. Else why 
so many cases in one family or community, or nation? 
Why so universal a disease ? Per contra, others have re- 
garded the disease simply as a decline, and as attributable to 
many causes, the family, community or nation being sub- 
ject to said causes. Some trust statistics. 

(b) Statistical. — At various times statistics have been 
compiled. The reader can judge of their value. They are 
gleaned somewhat as follows: Drs. A, B, C, etc., to the 
number of five hundred, are written and asked to answer the 
following question: "Do you consider tuberculosis contag- 
ious?" One hundred pay no attention to the letter, one 
hundred and fifty-seven answer in the affirmative, one hun- 
dred and forty-three in the negative and one hundred are in 
doubt. The compiler concludes: "The majority believe in 
contagion; great care should be exercised." Then follow 
rules for guidance — when, where and how to spit, etc., etc., 
etc. Others use reason alone. 

(c) Rational. — If it be true the plant tubercle bacillus 
naturally grows only in a soil produced by suspension of 
atmospheric influence; if it be true we can control, in the 
majority of cases, the soil so produced, it follows we hold in 
our hands a method of effectual control of tuberculosis, and 
that without germ intervention. This is the writer' s belief . 



— 168- 
Th e germ theorist reasons as follows: If the plant 
tubercle bacillus causes tuberculosis, there is danger. We 
must escape or destroy the germ if we would be safe from 
the disease. Cotton wool, germicides and serums are in 
demand. 

These same theorists might claim, if tuberculosis be 
caused by suspension, why shun the danger? One can no 
more catch suspension that he can catch a broken limb or 
a shooting star. The writer claims: True, one cannot catch 
a suspension, but he can avoid a suspension and thereby 
avoid the disease. This leads to another method which we 
call: 

(d) Synthetical. — We may hang our harp on the wil- 
low of imagination, yet the most skillful player brings forth 
only a weird and hollow sound. We are in a strange land. 
In all logical reasoning we must deal with facts. Let 
us try to give them : 

(a) Tubercle bacilli are everywhere present and cannot 
be eradicated. 

(b) They take root and grow when there is a favorable 
soil. 

(c) The soil is produced by suspension of atmospheric 
influence. 

(d) Suspension of atmospheric influence may be con- 
trolled. 

This means the control of tuberculosis — nothing more 
nor less. 

But suspension is already present: 

(a) From ignorance or neglect. 

(b) Heredity, for which we are not responsible or 
reprehensible. 

(c) Disease, to which we are all subject and some time 
must yield. 

Therefore, we must deal with facts as they are, and not 
as we ideally wish them to be. 

We have, then, two entities ever present, viz., suspen- 
sion or the soil, and the tubercle bacillus or the seed. The 



— 169 — 

soil and seed determine the harvest. 

"What shall the harvest be?" The seed cannot be 
sensibly limited. The output is constant. The soil cannot 
always be governed. It is sometimes beyond control. 

Mankind are truly frail creatures, yet when we once 
clearly recognize the true cause of tuberculosis and the 
means of prevention, I am satisfied the above vagaries will 
be forgotten and the dreadful scourge tuberculosis will be 
sensibly diminished — the lessening not attributable to any- 
thing except a higher knowledge of the disease. Let us 
labor for this happy consummation, It will abundantly 
reward us. 



— 170- 



MEDICINE. 



The field of medicine is an extensive one. Bach prac- 
titioner, from his particular angle, views to the extent of 
vision. As when one looks on the lake or ocean he sees as 
far as he can see, so when one introduces or examines a 
system of medicine his field is commensurate to the percep- 
tives exercised. No two people see exactly alike. No two 
have the same perceptives. Hence, the diversity in vision 
and perception. 

As in a coast survey many angles are taken before a 
complete map is made, so in medicine each should assume 
many angles before establishing a system. Many of us are 
extremely narrow. A system should be like the ocean, 
comprehensive and deep — so comprehensive as to include all 
knowledge, so deep as not to be readily sounded. A system 
of similar magnitude demands attention today. 

Nothing is more evident than that present medicine is 
beyond the comprehension of any! To some it is neither 
here nor there — a veritable ignis fataus. 

Competent men have declared there is no such thing as 
medicine, and, to their own satisfaction at least, have proved 
it. "When Bishop Berkeley said there is no matter and 
proved it, 'twas no matter what he said/' So when the 
medical nihilist says there is no medicine and proves it, 
there is no medicine in what he says, and ordinary mortals 
believe it. A practitioner who gains this idea had better 
drop from the race. Honestly, he has nothing to do — a 
disease, but no remedy. 

Others declare medicine is uncertain. What is not un- 
certain in this life ? To strike out the uncertain things 
would not only root up medicine, but law and theology as 
well. Medicine is far more certain than either. In truth, 
what could exist ? The farmer would no longer till the soil, 



—I7i — 

crops are so uncertain. The merchant would not cross the 
ocean or venture in trade, it is uncertain. It is said noth- 
ing is certain in this life except death and taxes. These are 
uncertain in time and magnitude. If we hold fast only to 
the certain things, poverty would soon be the lot of all. 

Say some: Medicine is empirical. The first treatment 
of disease must be empirical. We know as yet absolutely 
nothing. We gain our information from observation and 
experiment. Human nature is full of ailments. Nature's 
store-house is full of remedies. We seek to determine what 
will alleviate distress or aid nature in removing disease. 
Various ingredients, singly or combined, are tried and the 
results made known. This is empirical. When like results 
are obtained by a consensus of observers this is then called 
science in medicine. How else could the value of a remedy 
be determined than by experiment ? How else the worth of 
a medication than from observation? Experiment or ob- 
servation at the first must ever be empirical. 

As the world becomes older, as disease and remedies 
become known, we have not only all past experimentation 
and observation, but also a large field for original research. 
In this field we are placed as at the first. It is one of un- 
known disease and untried remedies. So that so long as 
human nature remains as it is, subject to sickness; so long 
as the world remains as now, full of the untried, so long 
there will be the two distinct fields — experimental and prac- 
tical. These will be taken up respectively by parties best 
adapted to the work. The separate fields will not long re- 
main fallow or barren. Each will be cultivated and abun- 
dant harvests secured. 

For the past few years there has been a decadence along 
this line. This may be attributable to three or more causes: 

i. The desire of some to shine in medical literature 
before a proper standard of refinement is attained. The}- 
who closely follow these writers do not see the same results 
as shown. We must then unlearn what is learned amiss. 
This retards progress. 

2. Experiments on animals are assumed to give iden- 



— 172 — 

tical results as the same experiments made on man. As- 
sumption is not always truth; many times it is the opposite. 
This we all learn sooner or later. 

3. Another fault should be readily seen. Experi- 
ments made on the healthy animal are assumed to produce 
the same result as if made on diseased man. How a 
rational being could make so illogical an assertion is past 
finding out, yet such seems to be. That similar statements 
are made may be ascertained by consulting the ordinary 
text-book in medicine. So many grains of calomel, etc., 
produce a certain condition or result in healthy dogs, rab- 
bits, guinea pigs, etc. If given to diseased man we expect 
similar results. We may expect, but, as a matter of fact, 
we do not see. Any practitioner knows that Messrs. A and 
B may be alike diseased and a remedy given to the one will 
not always produce the same result if given the other. 
Mankind differ in susceptibility both in health and disease. 
How, then, could we rationally compare the action of reme- 
dies in health and disease, much less in animals diverse in 
nature and habits ? 

These are among the irrational things found in medi- 
cine. There are many others equally as flagrant. 

4. As a small observer of the times and seasons, we 
must also think this decadence is due in part to the drop- 
ping of the old and tried remedies and the grasping for the 
new. This is seen more particularly in the adoption of the 
various serums in the treatment of disease. It is observed 
in certain conditions that germs or microbes are found grow- 
ing. Why they are thus found is not asked, but the con- 
clusion is at once reached that they cause the condition or 
disease named. How to eliminate or dislodge the microbe 
is the question for solution — no other. The various meth- 
ods proposed would baffle the forest hunter in his search for 
game. A trap, snare or gun would constitute the hunter's 
outfit. Not so the germ-hunter. He proposes to secure 
the invader by means of his own extract — a novel method. 
What is also remarkable, the extract must be of a certain 
brand, usually foreign. This certainly appears dishonest. 



—173— 

The writer thinks all dishonest methods should be shunned, 
even though they assume the guise of novelty. Wrong is 
wrong. 

This method of treatment being so contrary to reason, 
some have tried to rule it out by means of ridicule. But 
ridicule is not argument. It does not convince. There is 
one way in which the inconsistency can be properly shown, 
and that is by comparison. Suppose you discover a drove 
of hogs in your neighbor's potato patch. What is your 
first honest impulse? To inform the neighbor. What is 
the neighbor's impulse ? Perhaps to swear, then to remove 
the hogs, repair the fence and ask for damage. What is 
the future action ? To keep the fence in repair. This is 
an order of sequence. As a physician you discover growing 
tubercle bacilli in a patient's lungs, or perhaps, better, a 
condition of system in which the bacilli will soon enter and 
grow. You are paid for the discovery. What should be 
your honest impulse ? Should you spend the entire time at 
the expense and danger of the patient in trying to trap, en- 
snare or kill the growing bacilli by means of an extract ? 
Should you not act as well, as sensibly, as honestly, by a 
patient as by a neighbor ? If not, why not ? Should one 
spend the entire golden hours of the precedent state, and 
while tuberculosis can be controlled, in vainly endeavoring 
to secure a possible immunity to the germ ? This is what is 
being done. 

When one looks about him and sees the inconsistency, 
the foolishness, the dishonesty of his fellows in medicine, he 
is led to exclaim: "Great God ! Can it be possible man is 
created in Thy image?" Brethren, repair the fence ! 

Medicine not subject to law ! We are accustomed to 
see things move with regularity and precision. The sun 
and moon rise and set at regular intervals. Mankind are 
born, they grow and die. Waters run, smoke ascends, the 
tide rises and falls. These things we are accustomed to 
and of them we take but little note. In medicine things are 
different. Here there is no regularity. For pain or sick- 
ness one takes nothing, another medicates, a third prays. 



-174— 

and all complain. Each thinks his the proper way. Why 
this diversity ? Why not more unanimity ? Why not a 
universal method ? 

How in regard to theology ? One believes in God and 
prays, another believes in God but not in prayer. A third 
believes in neither God nor prayer, etc. , etc. In truth, we 
find many peculiar beliefs. 

Note this connection in medicine and theology: Nearly 
all bel : eve in something; the lack, if any, is in unanimity cr 
method. This lack, in medicine, is the one thing of all 
others which makes the field so extensive. Each has a 
field. No two fields are alike. A system must compre- 
hend or include all fields. There seems to be no other or 
better way. I>et us enlarge our borders. 






— 175 — 



DEEP BREATHING VS. TUBERCULOSIS. 



One-half of the earth's people are poorly fed. The 
reason is obvious. It is not that Mother Earth fails to 
yield her sixty or one hundred fold, but that the hand has 
been negligent or slothful in preparing the soil or planting 
the seed. 

Prosperity and effort are closely allied. "The hand of 
the diligent waxeth rich." Indolence has no incentive to 
labor. As a rule, famine stalks rampant in its fields. India, 
today, is an illustrious example. We note also famine and 
its twin sister, pestilence, thrive most among the heathen or 
half-civilized. Christian civilization knows nothing of fam- 
ine and little of pestilence from personal experience. They 
are practically driven from its borders. 

While we thus exalt civilization of this generation we 
must also note some of its faults or defects. Foremost among 
these is imperfect aeration of the blood. A vast majority of 
the civilized are consuming less oxygen than they should. 
The reasons are multifarious. 

One would naturally think the primary cause for this 
fault, defect or wrong consists in ignorance of the value of 
oxygen. The writer is inclined to think this view an in- 
correct one. The civilized are well informed. That it is 
not ignorance alone is certain from the fact that physiology 
is taught in all the public schools. The laws of the land 
allow or compel attendance at these schools, so no plea of 
ignorance can be raised. 

But why is it assumed there is imperfect aeration among 
the civilized ? What is aeration ? Aeration is ventilation 
of the blood as it passes on in the life current. Aeration 
takes place through the lung tissue. It naturally occurs in 
no other way. The lungs of man, as the gills of fish, per- 
mit the oxygen to enter the system. If the lung tissue be 



— 176 — 

imperfect, thickened, or in any way defective, aeration i^ 
incomplete, i. e., insufficient oxygen enters the system. 

Should one consume less food than is required by the 
system, or should the food be of imperfect quality, there 
is a starvation of the body. The same may be said of oxy- 
gen. One who takes in or consumes less oxygen than he 
should, either from ignorance, perversity or inability, the 
system must suffer. In one sense it is oxygen starvation or 
famine. 

Should one by deep breathing or inhalation take in 
more oxygen, or should one breathe a purer air and thereby 
receive a larger supply, every want in the system is met and 
the famine is declared off. This is what deep breathing 
does in certain states of the system. It removes the famine. 

But first, why is it thought there is imperfect aeration 
among the civilized? One-seventh of all deaths are due to 
consumption or phthisis pulmonalis alone. If we add to 
this number others who die of distinctly lung disease, as 
pneumonia, etc., the proportion seems abnormally large. 
No such proportion is seen among native tribes remote from 
civilization. To the writer, the reason seems obvious: 
They have a more perfect aeration. The perfect aeration of 
native tribes secures a practical immunity from lung disease. 
Civilization can show no such immunity. 

What does aeration accomplish ? As the oxygen enters 
the lung tissue it comes in contact with the venous blood 
and changes it to arterial. The impure blood is thereby 
rendered pure. The body, by this means, is kept in a 
healthy condition. This of itself is one of the essentials to 
long life. In order to have pure blood our food must be 
ample in quantity and quality. The oxygenation of the 
blood is just as essential. 

We look on famine-stricken India with hearts of pity 
and sorrow. Pity, there is so much suffering; sorrow, the 
people are so unwise and improvident. India could look on 
us with the same commiseration. The Americans and 
Europeans are so talented; they have every resource of art., 
science and literature, yet they are actually dying of starva- 



—177— 

tion— an oxygen famine. The East India men should help us. 
No doubt they would had they the zeal and knowledge. 
The zeal, perhaps, could be attained by a better food supply, 
the knowledge by the exercise of an acute observation, cer- 
tainly not by consulting standard authors, who tell us so 
much of disease germs and their action. 

What else does aeration of the bloo d accomplish? The 
food we eat sustains us or builds up our system as we digest 
or assimilate the same. Without digestion and assimilation 
there can be no true growth or strength added to our frame. 
To every student of physiology it is known that the lacteals 
empty the chyle, for the greater part, into the thoracic duct 
and from thence it is poured into the venous circulation. 
All chyle passes into this current. It here becomes subject 
to aeration in its round of the circulation. What does area- 
tion do to this new current which enters the channel for the 
first time ? It seems this is the last creative act, if we may 
so speak, in the formation of the new blood corpuscle. If 
so, it must be a very important one in the animal economy. 
New blood corpuscles are being formed, while at the same 
time the old are revivified. These two actions are con- 
stantly going on during aeration, are imperfectly performed 
during imperfect aeration, and stop when aeration ceases. 
It is seen that if every part of the human machinery be in- 
tact except aeration there is here found sufficient cause for im- 
purity of the blood and scantiness of the red blood corpuscles. 
We may give eliminatives, we may ingest a better food sup- 
ply, we may order / err urn redactum ad libitum, but we do 
not reach the true cause of the difficulty until we establish a 
more perfect aeration. 

Herein lies a secret in the treatment of many diseases. 
The disease tuberculosis, which is caused, we are told, by 
the germ tubercle bacillus, originates in this way. The 
first stage of tuberculosis is simply a faulty aeration. The 
bacillus enters secondarily — is never a cause of the disease. 
The faulty aeration may be due to many causes, but the re- 
sult is one and the same — tuberculosis sooner or later. The 
-remedy lies in the correction of this fault. It may take 



-178- 

years to teach this simple truth, but it will eventually be 
accepted, and we will look back at the amazing folly of hav- 
ing once thought an infinitesimal germ caused the serious 
disease tuberculosis. Colorado's burden will then be les- 
sened and the world will breathe freer and easier, with a 
purer blood supply and an enlightened conscience. It is this 
field of original research that has remained so long fallow 
that is destined to yield an abundant harvest on proper cul- 
tivation. Let us each, with God-fearing assiduity, sow and 
reap as best we may and patiently await our reward. It will 
assuredly come and that with thanksgiving and joy. 

We stated the quality and number of the red corpuscles is 
dependent on the perfection of aeration. Let us see if this 
be correct as to its practical workings. Take, for example, 
the ordinary student life at college. Of course, we are 
aware there is great difference in the student life of today 
and that of twenty years ago. There has been improvement 
on the social side, larger physical culture, more out-door 
exercise, etc. In fact, there has been a constant change, 
and that for the better. Yet, after all, student life is stu- 
dent life — a host of duties, incessant cramming, and for the 
studiously inclined, but little exercise. Many students are 
constantly tired, easily exhausted, nervous and irritable. 
What is lacking? A pure blood supply. Of this there can 
be no question. What is the remedy? Physical exercise 
in the open air, more perfect aeration of the blood or hema- 
tosis. In the writers judgment there is no question but that 
mental and physical training should be conjoined. All 
schools should be conducted on this basis. 

For further illustration take the ordinary housewife, 
who does, for the greater part, her own work. What is her 
life ? A constant round of duties in her household, never 
fully done. From early morn till latest eve it is constant, 
never-ceasing work. "A woman's work is never done." 
What are her cares? For family, home and self. Self usu- 
ally comes last. Her wants are many, but her greatest is 
pure oxygen in her own home, or time and opportunity for 
out-door exercise. She regards neither, but toils on , a poor 



—179— 

weak, anemic creature, and dies, most often, of phthisis 
pulmonalis. Could her untimely death have been avoided ? 
Is civilization in any wise to blame ? These are questions 
the twentieth century will be called to answer. Is not their 
consideration proper now ? 

But perchance the woman's sphere is not among the 
toiling millions. Her life is one of so-called social joy and 
gaiety. It is calls, balls, parties and receptions, of late 
hours, untimely meals of indigestibles, society's loud call 
for dress improper, etc. The life, ill-ventilation, etc., 
cause rising with languor and the noon day sun. Envy, 
jealousy and rivalry enter this life, but not more often than 
imperfeet oxygenation of the blood. Society has yet im- 
portant lessons to learn. Who would dare dictate to fashion ? 

May be the life is that of a wage earner, and who is 
not ? If so, it is so much work for so much remuneration. 
We enter not the vexed question whether the pay be suffi- 
cient for the labor. This is left to others. The question 
with us is, is the ventilation ample. Workmen are often 
crowded; the air space is insufficient and the room is dusty, 
or perhaps the lights are consuming too much oxygen. 
The remedy must meet the requirement. 

In all these cases systematic deep breathing in the open 
sir will overcome the difficulty if taken in time, provided the 
fault be remediable. It will benefit the patient even though 
the cause be continued. But the benefit in the latter case 
will not, of course, be permanent. Permanent benefit means 
freedom from tuberculosis. 

A question now arises: What faults are and are not 
remediable? If the fault be not enough oxygen in the 
room, if an irritant dust, gas or vapor, if a use of the upper 
air passages of the chest only, due to tight lacing or other 
cause removable, these are remediable. If by heredity we 
receive a lung tissue incapable of perfect aeration under the 
most favorable environment, if from continued exposure, 
taking cold or other cause we acquire a thickened lung tis- 
sue incapable of perfect aeration, these, of course, are not 
remediable. Deep breathing cannot alter permanently an 
hereditary or acquired lung tissue. Deep breathing calls 
into exercise the healthy lung tissue we possess, and aids 



— i8o— 

the patient in his effort to secure a better blood supply. 
This alone places him on a higher plane of health and enables 
him to more effectually resist the encroachments of disease. 
In other words, one who so acts keeps his system in a con- 
dition in which the germ tubercle bacillus does not enter and 
grow. He who so acts has a -perfect immunity to the dis- 
ease tuberculosis. The number of germs in the atmos- 
phere is of little moment provided there be a perfect aera- 
tion of the blood. 

Now please understand we do not advocate deep breath- 
ing as a cure-all for every disease. Systematic deep 
breathing, if the lung tissue be healthy, will insure a pure 
blood supply in so far as oxygenation of the same is con- 
cerned. Oxygenation of the blood, it will be found, is the 
essential element in the prevention of the precedent state, 
or first stage of tuberculosis. If true, how essential is per- 
fect aeration in the prevention of the disease. If true, the 
law of tuberculosis stands demonstrated: The death-rate 
from tuberculosis is in direct ratio to abeyance of atmos- 
pheric influence. 

Deep breathing does more than the oxygenation of the 
blood. As a preventive to taking cold or the ordinary 
catarrh it perhaps has no equal. Deep breathing, then, not 
only prevents tuberculosis directly, but it also prevents the 
very causes which lead to the same. How essential is deep 
breathing ! 

It seems to the writer this article is incomplete until a 
relation between deep breathing and physical exercise is 
shown. In one sense deep breathing is physical exercise. 
In another sense physical exercise is deep breathing. Yet 
it must be evident to all they are not one and the same. 
One may breathe deeply with little exercise. One may exer- 
cise violently yet breathe shallow. Physical exercise should 
be such as to cause perfect inhalation and exhalation. 



— 181- 



AN AHERICAN NEED. 



"A just observation and reflection upon men and things 
give wisdom; these are the books of learning seldom read." 
— Wm. Penn. 

The Americans as a people are well educated. Many 
things conduce to this end. Foremost among them a sys- 
tem of common schools prevail throughout the length and 
breadth of the land — the pride and joy of the nation. The 
children, when grown, have vivid recollections of these 
schools. Not only do they remember, but the habit of 
thought then and there formed follows them in after years. 
Early life is a period of inhibition; not only so, we also re- 
tain what we see or hear. 

The child at school may be compared to a sponge. 
Whatever is presented is readily absorbed, so that, squeeze 
whenever you will, the child or man gives out that he has 
absorbed or inhibited. This is a sequel to the present sys- 
tem. Whether it be regarded a fault or not, this much is 
certain: There is not that in us which tends to a vigorous 
growth or development. As writers and teachers we lack 
originality and force. The writer believes this a fault, 
one that should be corrected, or in some way avoided. It is 
our life. Wherein does the wrong or fault consist ? In 
this: We take in or assimilate as presented; we memorize 
and give out just as we receive. Such teaching or instruc- 
tion develops no originality. It is a parrot-like acquire- 
ment and delivery. Ages come and ages go and we roll on 
forever so. 

It is a similar system which has brought the Chinese 
empire where it is today. No people on this earth are bet- 
ter educated than the Chinese. Yet in true progress and 
clear ideas where are they ? One thousand years behind 
the age. May it never be so said of America. 



It is not the object to find fault with a system of edu- 
cation the like of which is not elsewhere to be seen— the 
rather to commend it. At the same same time it must be 
remembered that all human systems are faulty. To elimin- 
ate a fault is to improve the system. Do we desire improve- 
ment ? Why object to an- elimination ? 

As before stated, in early life the receptive faculties are 
open. This is as it should be. The child imitates, receives 
and retains. As yet there is no cultivation of the percep- 
tives. The child sees nothing except through his teachers. 
As he grows why not occasionally let him look for himself ? 
He passes from grade to grade, and, if studious, becomes an 
encyclopedia of information, yet destitute of originality — a 
mere book worm. 

As the best pastor endeavors to find work for each of 
his parishioners, and thus adds to or improves his talent, so 
the most capable teacher strives to develop in each pupil his 
powers of perception or originality. This is wise. Ency- 
clopedias are common. Book- worms are unnecessary. 
What the world wants is original thinkers for its advance- 1 
ment. The sooner we discover this truth the better for 
mankind. No discovery is probable by one who has been 
educated under the present system. The system itself blinds 
one to original research. It is a continual memorizing of 
what others have passed on or determined. 

That the writer is not giving vent to an hallucination 
may be seen by observing the high school graduate as he 
leaves his alma mater. Watch him ! His unaided ability 
to secure a position and adaptability to gain a footing in the 
"struggle for existence" is child-like. He is a mere tyro. 
Place him on his feet, tell him what is to be done and how 
to do it, show him what is expected of him, and if he be 
faithful he learns more of practical wor th in one year than 
in the many years previously. The world's book of prac- 
tical suggestion and infor?nation is now o-pen to him for 
the first time. Is he educated to read this book ? W& 
ihiuk not. 



-i8 3 - 
The same may be said of the ordinary college graduate. 
Note the length of time before he finds a place adapted to 
his abilities. When out of school he is like a landsman at 
sea. Perhaps he begins with some menial employment much 
to his distaste, if none^other offer. By diligence he rises 
step by step and from his chaos of information he discovers 
there is little available at present. The bent of inclination, 
or more often the solicitations of friends, determines his vo- 
cation. All may go well. Very often everything goes ill, 
or it is rough sailing from the start, and the voyage proves 
uneventful. 

The great trouble is we are made too dependent on some 
one else. Teachers are not always present. There are 
some things we must observe for ourselves, else we do not 
know. Birds and flowers and trees, etc., do not grow with 
names stamped on them. 

To be familiar with these objects we must learn them 
from nature in nature's school. So in science; science of 
today is not the science of yesterday or tomorrow. It is 
changing. He who reads science truly must walk as in the 
day, with both eyes open, recognizing all men, -paying 
deference to none. He alone can read wisely. 

"A just observation and reflection upon men and things 
give wisdom; these are the books of learning seldom read." 
Give us more self-reliance and greater originality; these are 
potent factors in the world's evolution. 

After the classical course in the schools comes the fit- 
ting of oneself for professional life — a great w T ork. It is 
said the major part of our great men are college bred. This 
at best, is saying but little, for all of our children must have 
more or less of college training. If, then, w T e have distin- 
guished men at all they must of necessity be from this class. 

The question under consideration is, do our strictly 
college-bred men show marked traits for original research ? 
Are they distinguished along the lines of acute observation ? 
Do they not work in channels or grooves in which they have 



— 184— 

been taught? Do they not hold and reverence the authori- 
ties ? Are they not, as a rule, inferior in wisdom to the so- 
called self-made men? 

Our greatest .artists have ever copied from nature. 
Why should we, the students of nature, ever be following 
the scholastic method ? 

Let us think wisely, but let us think for ourselves, re- 
membering there are "Sermons in stones, books in running 
brooks and good in everything." 






-185- 



THE DAWNING 



Within memory of the present writer a health officer 
declared one dying of consumption should not be carried in 
a public conveyance unless the casket be hermetically sealed. 
Reason: The danger from germs is so great the public de- 
mands precaution and protection. 

Germs, in some localities, are yet considered dangerous 
— dangerous in that their true action or condition of growth 
is not clearly understood. We must live and learn. 

Thanks to an enlightened public sentiment, the above 
order is obselete. Other orders will be obselete ere long. 
The light is gently breaking, and soon we will behold the 
sun in his effulgence. The writer thinks he will bring heal- 
ing in his wings. Give us the light ! 

For the past tw T o decades we, as a people, have been 
harassed by the announcement that milk and its products — 
cheese and butter — are full of tubercle bacilli. We have 
also, during the same period, been studiously taught that as 
tubercle bacilli cause tuberculosis, these products are dan- 
gerous and should be inspected. A government inspector, 
as in Germany, has been urged. They say the people 
should be taxed and microscopists should pass sentence on 
all milk products placed upon the market. In this way 
tuberculosis could be controlled. In the meantime, until 
such inspection, we are advised to avoid cheese, boil butter 
and sterilize the milk, some even going so far as to counsel 
the eating of butter while hot through an aseptic tube. 

The writer, in his weak way, at various times has de- 
nounced these statements as fallacious. In the first place, 
he argues that tubercle bacilli do not primarily cause tuber- 
culosis. Tuberculosis is a constitutional disease, is based 
on law and the bacilli enter secondarily. The constitutional 
disease allows the natural entrance and growth of the 



-i86— 

germ. On this topic the author challenges controversy. 

If tuberculosis be a constitutional disease, the disease 
preceding the germ's growth, milk is a diseased product 
before the entrance of the growing germ, therefore, kill- 
ing the germ by sterilization would not render it a perfect 
milk. This was shown by the writer in 1894, {vide Tran- 
sactions Ohio State Medical Society.) 

If the milk be imperfect, milk products are also imper- 
fect, and no microscopist could detect this imperfection by 
the presence or absence of tubercle bacilli in said product. 
Microscopical inspection is therefore a useless expense. We 
pay taxes enough in this direction already. 

As stated, the writer has attempted to clear the way for 
microscopical entities. The replies have not been numer- 
ous; in truth, as a rule writers have stood aloof. Is there a 
reason why ? From the hills of New Hampshire we receive 
the following: 

DANGER FROM MILK OVER-ESTIMATED. 

"Experiments as well as observations made in the last 
few years lead us to believe that tuberculosis is much less 
often communicated to man through milk than was former- 
ly supposed." — New Hampshire Sanitary Bulletin, January 
1900. 

A closer observation, we feel assured, will lead to the 
conclusion that tuberculosis is not conveyed in this way at 
all, only under certain conditions. These will be spoken of 
later on. 

But who are making these experiments and observations 
and what is their intrinsic worth ! The professors of the 
United States agricultural experimental stations are largely 
doing the work. The reports are of value according to the 
ability, honesty and common sense of the ones making them. 
Honesty we naturally expect. Some men are down-right 
liars. Common sense and ability, like twin sisters, walk 
hand in hand. Sometimes they are found alone, but only 
for short periods of time. They soon come together. They 
think so much of each other that they are close companions; 
nothing can separate. So far as we can ascertain, these 



ir en, for the major part, are germ theorists. 

For convenience, we divide them into theorists of the 
first and second waters. Theorists of the first water believe 
the germ -per se is all in all. Prof. Robt. Koch and his con- 
geners belong to this class. Men of this stamp believe 
germs are veritable Napoleons, carrying devastation, disease 
and death. Theorists of the second water believe there are 
germs and germicides; also a few other things worthy of 
notice. Dr. Russell, of Glasgow, Scotland, and Prof. Rus- 
sell, of the Wisconsin station, are men of this class. They 
believe germs have a mission, but it is inferior to the mis- 
sion of the being they infest. In other words, _, men are 
superior to microbes. 

It is a common impression that first- water men are 
graduates cf German schools, while second-water men have 
not crossed the North Atlantic. This is a mistake. Many 
first-water men are found who never crossed their state line, 
while some second- water men have visited many cities of 
Europe, and vice versa. Where one has traveled is of little 
worth. What does he know? This is what the world is 
"asking. This it will ultimately find. One may deceive 
himself forever. He can deceive the vast intelligence of 
mankind but for a short time. Deception is short lived. 

From the Storrs Agricultural Experiment Station of 
Connecticut, eleventh annual report, we find experiments 
were made by feeding eight calves with milk from tubercu- 
lous cows, and that without infecting the former. These 
calves were fed for periods varying from three months to 
sixteen months without developing the disease. The report 
is closed in brief, from which we extract the following sen- 
sible words: "We kmfw comparatively little regarding the 
■conditions which favor the spread and development of tub- 
erculosis among animals or man.''' Evidently, the above 
was penned by a germ theorist of the second water. The 
second water theorist knows but little in his own estimation; 
the first-water theorist knows it all. When one rises to the 
admission he knows but little, he is in position to take the 
first step to obtain more.; when ©ne knows it all there is no 



incentive. He is practically dead and only needs burial. 

That little is known, as yet, regarding the condition s 
which favor the spread and development of tuberculosis 
among animals, may be seen by consulting Bulletin 108, 
June, 1899, issued by the experiment station located at 
Wooster, O. Ohio as a state is in many regards a leading 
one. The presumption is our men at Wooster are as com- 
petent as others. Why not ? 

"The herd of cattle at this station was established in 
1894, by the purchase of a bull and two or three cows, each 
of the Jersey, Guernsey, etc. . . . At the time these 
purchases were made the idea was prevalent that the tuber- 
culin test might be injurious to the health of the animal. 

. For this reason the test was not insisted upon, etc., 
etc. On the station farm they were, of course, given good 
care, etc. All the increase was retained and by the spring 
of 1897 there were about eighty animals in the herd, all 
apparently in perfect health except two — a short horn cow 
and a Jersey bull, which had begun to show evidences of 
disease; the cow by rapid loss of flesh and the bull by the 
growth in the throat of a visible lump, which caused diffi- 
culty in breathing. At the beginning of June both of these 
animals were killed, after having been subjected to the tub- 
erculin test. The cow was found to be in the last stages of 
generalized tuberculosis, and the lump in the bull's throat 
was found to be due to the same disease. A supply of tub- 
erculin was then procured and in December and January 
further tests were made, and on June 8, 1898, fifteen cattle 
were slaughtered." — An Outbreak of Bovine Tuberculosis 
at this Station, p. 295. 

Then follow temperature before «and after these injec- 
tions, and the result as found after death — a very interesting 
report. 

These gentlemen should be congratulated. But the 
writer is not satisfied, in that the report is incomplete. It 
is incomplete in that the same number of animals were not 
chosen by the tuberculin test and placed under similar con- 
ditions. We would then have two lists of animals, one 



— 189— 

chosen by general appearance or inspection and one by the 
tuberculin test. Should the first lot develop tuberculosis 
we could say, as in this case, it is lack of the tuberculin test 
in selection. Should the second, "after the test, develop tub- 
erculosis, what could we say ? Either the test is inefficient 
or there is other cause of tuberculosis. Which would it 
be ? The writer asserts that after the tuberculin test tuber- 
culosis will develop, though more slowly. Why? 

In an article (Lancet-Clinic, November 20, 1897,) the 
writer held these conclusions: 

(a) Tuberculin determines the presence of growing 
bacilli. 

(b) Tuberculin has no value in diagnosis. 

(c) Tuberculin has no certain value in differentiation 
of first stage. 

(d) Tuberculin is sometimes dangerous. 

The writer holds these conclusions tenable. But our 
method of experimentation would be along a different line. 
We claim the precedent state is the first stage of the disease 
tuberculosis; that this state is caused by suspension of at- 
mospheric influence and is based on law; that suspension 
takes place from within and from without. Our questions 
for answer would be as follows: 

1 . Does suspension of atmospheric influence cause a 
condition of system that allows the tuberele bacilli a natural 
entrance and growth ? Take a healthy animal and subject 
it to this test. Answer, yes or no. 

2 . Is there more than one method of suspension ? 
Experiment on an animal. Answer, yes or no, 

3. Is there an anatomical difference in the lung tissue 
of health and of heredity, or of acquired influence ? Sub- 
ject the lung tissue of each to rigid microscopical examina- 
tion or other scientific test. Answer, yes or no. 

4. Is there a test, chemical, microscopical or other- 
wise, which will determine the difference in the blood cf 
health and that of suspension of atmospheric influence ? 
Has science a delicate test ? Apply this test to the livirg 
animal. Answer, yes or no. 

When these experiments have been made and correctly 
answered the law of tuberculosis will read as follows: The 
death-rate from tuberculosis is in direct ratio to abeyance of 
atmospheric influence, 



290— 



MATHEflATICS IN MEDICINE. 



In my boyhood days I taught a winter school in the 

village of R . On entering the school building early 

one morning I found written on the blackboard the following: 

x }y *z 
x y =* z 
The value of z, please? 

A question at once entered my mind. Who wants a 

solution ? Several weeks later I learned a Mr. , who 

had taught in the village , desired one. 

Algebra is used but little in medicine, yet the writer 
thinks its introduction would lead to more accuracy in defi- 
nition, solve many hard problems and clear up some points- 
now obscure. 

In illustration, take the word heredity. What is meant 
by heredity ? The author defines it a prenatal inheritance. 
Whatever one receives in bone, blood, muscle, etc., prior to 
birth is by heredity. 

Let us see if this be true. Suppose one or both parents 
have a constitutional disease. Does the definition hold ? If 
not there is a mathematical inaccuracy. If true, there is hered- 
ity in every distinctly blood disease, etc. We quote from 
"Tuberculosis or Consumption" as follows: ^ You have a 
son to send to college. You call before you five leading 
clinicians in this state and put to each the test question : 
What factor is heredity in tuberculosis ? Listen to the an - 
swersr Nothing, little, much, a great deal, all. What arises 
in your mfctd ? One of two things— either these teachers 
are deceiving you or else they do not understand the busi- 
ness they profess. If/w can instruct exceft they who 
know?''' 

But, replies, a germ theorist, if tuberculosis be caused 
fay a germ,, which we have every reason to believe; if the 
growing germ be not transmitted,, as experiments seem to 



i 



—I9i— 

show, what matters it whether heredity be much or little ? 
Let us see: "It would seem much easier to formulate a co- 
hesive and rational theory of the propogation of tubercular 
disease by infection than to account for it by heredity." 
(Ohio Agricultural Experiment Station, 1899, Bulletin 108, 
page 364.) 

The writer thinks this statement manifestly unfair. 
Remember, it is a public document, paid for by the great 
State of Ohio. The present writer has no motive other 
than the advancement of medical science. He has a right to 
ask fairness. In what does the unfairness consist ? In the 
ambiguous word heredity. Does heredity mean [nothing, 
little, much, a great deal, all? Much depends on the an- 
swer. The majority of germ theorists claim heredity is 
nothing. In place of heredity put nothing, and then read: 
"It would seem easier, etc., to formulate, etc., by infection 
than to account for it by nothing.' * Not only would it seem 
easier but it would be easier. Of this the ^ writer feels 
certain. 

Who claims heredity is all ? Perhaps, all told, about 
five persons in the United States. To whom, then, is the 
committee of this experiment station talking ? To these 
five. What does the great majority of the medical profes- 
sion hold? That heredity is a factor in tuberculosis — a 
variable factor. In some cases more, in other cases less. 
Refer to history. We will attempt to explain this later. 

Now look at the unfairness of the above statement in 
the light of mathematics. To compare a factor or part with 
an entity or whole as to the formation of a theory. Mani- 
festly unfair ! One thing should be required of all public 
servants, viz., accuracy of statement, mathematics in defi- 
nition. 

Says the same authority on next page (365): "In dis- 
cussing the question of heredity we should keep clearly in 
mind the biological meaning of the term," Exactly. This 
is just what the germ theorist does not do. The germ 
theorist claims the germ grows indifferently in any soil, i. e. , 
the germ tubercle bacillus is the cause of tuberculosis. The 



— 192 — 

writer says not so. A soil must be prepared, i. e. y the soil 
must precede the growing germ . The germ theorist says that 
heredity is practically zero. The spread of the disease is 
from the germ alone. The writer says not so. Heredity is 
a factor. A soil may be transmitted. This soil aids in 
spread of disease. What is the order of the biologist ? Soil, 
plant, growth or fruitage. Who keeps the biological mean- 
ing most clearly? Mathematics in statement is required. 

Why is heredity a variable factor ? Simply because it 
does not occur in two cases just alike. I^et me illustrate. 
A father has tuberculosis; his partner in life is in good 
health; heredity in the child is one factor. Both parents 
are in good health; heredity in offspring of these parents is 
another factor. Both parents have tuberculosis; the child 
in this case is still another factor. The mother has tuber- 
culosis, the father is in good health; the offspring are other 
factors. And so on ad libitum in as many conditions as the 
parents may be found. 

Again, the parents' occupation, environment, etc., 
cause a variable condition of blood due to perfect or imper- 
fect aeration, and this continued in the parents and trans- 
mitted to an offspring cause variation in heredity as a factor. 

The great body of physicians in America are as honest 
and as competent as any physicians on the face of this earth. 
In saying heredity is a factor in tuberculosis they express a 
great truth. It is a factor. But we must look yet further. 
Heredity is not the cause of tuberculosis. The cause is 
suspension of atmospheric influence. Heredity as a factor 
aids this cause in the extension of the disease. 

Moral: In the prevention of tuberculosis heredity must 
be regarded in connection with suspension. 

A question is now presented to the germ theorist, viz.: 
Why the diversity of opinion, past and present, in regard to 
heredity if the germ theory be true ? In heredity what is 
transmitted ? If there be transmission at all there must be 
an entity. 

In order to understand this rightly, one must first clear- 
ly comprehend the law of tuberculosis. What does this law 



—19 



teach or show ? In every case of suspension from whatever 
cause, there is first an impurity of the blood due to imper- 
fect aeration. This, if continued, leads to a condition of 
tissue favorable to the growth of tubercle bacilli. The 
tubercle bacilli ma}' be ubiquitous, but the} 7 are not omnis- 
cient. They grow, but they grow as all plant life — in a soil 
prepared. 

Now take this truth and use it in connection with hered- 
ity. What is the entity transmitted in heredity ? A pre- 
pared soil. We have, then, in heredity an identical condi- 
tion as in suspension at the first. Suspension creates a soil 
and heredity transmits a soil and they (the soil) are one and 
the same. 

Illustration: Mrs. A. has poor ventilation in her home. 
She becomes pregnant. During the months of gestation 
the imperfect aeration continues and it induces an impurity 
of the blood and a condition of the system or tissue favora- 
ble to the growth of the tubercle bacilli. The fetus receives 
the same blood and the same condition of tissue. Is this 
clear? This is heredity in the child. 

Should tubercle bacilli be found growing in the mother 
they may sometimes be found growing in the child. In 
either case, the mother or child alike allow the growth. 

Or, perhaps better, let the illustration be taken from 
life. Mrs.T., of E., has tuberculosis. She becomes preg- 
nant, and in due time is delivered. (I often wonder if abor- 
tion in some of these cases would not be justifiable.) The 
mother having suspension, there is suspension in the child, 
for, according to the author, in every case of tuberculosis 
there is suspension. Here, then, we have a babe ready for 
the growth of tubercle bacilli. In some few recorded cases 
the bacillus is found growing at birth. Dr. Jacobi, of Xew 
York, mentions such a case. Dr. Russell, of Glasgow, says: 
"These cases have an academic interest," thereby acknowl- 
edging their authenticity. The author thinks they have a 
greater interest than this. They have a world-wide inter- 
est. They prove a soil may be transmitted by heredity 
alone. Yet there are men in high places who deny to hered- 



-194— 

ity a value, and that before large classes. What astounding 
effrontery in the light of observation, reason and common 
sense. 

We now hasten to discuss another phase of this ques- 
tion. When a soil is induced by heredity, can it ever be 
changed back to its original condition? That depends, as 
in suspension, assuming there be simply a blood change or 
slight change in the tissue — yes. If the change be to dis- 
organization — no. Destroyed tissue cannot be restored. 
Again, should there be disorganization with immense num- 
bers of tubercle bacilli, as there usually is, all effort to re- 
store health is in vain. The patient dies. Should enough 
sound lung tissue remain to insure fairly perfect aeration, 
under favorable conditions, health may be restored, though 
not normal. 

In what way may this change for the better be brought 
about ? Just reflect one moment. What causes the dis- 
eased condition? Suspension of atmospheric .influence. 
What removes the condition? Removal of suspension. 
The remedy is a simple one: Breathe pure air. 

Illustration: We stated Mrs. T., of E., is delivered of 
a child. What is its condition ? One of suspension. The 
writer stated plainly to the parents the method to pursue. 
Remove the child at once from the/breast, feed it cow's milk 
and let it have abundance of pure air. The mother said no 
— "If I die let the child die with me." Dr. W., of R., is 
called. He approves my opinion. The mother still says 
"No." An uncle, Dr. C, of C, is called, and he, holding 
the same belief, takes the mother to his home and leaves the 
child under the writer's supervision. In three or four 
months the mother is covered with the clods of the valley, 
but that child, today a man grown, is in perfect health. 
At the time of removal it was thought by the trio of physi- 
cians that the child would live but a few days. It had high 
temperature, colliquative sweats and hurried respiration. 

This history is but a counterpart of hundreds of others 
seen in every civilized land. Do all receive equally favora- 
ble results ? The writer thinks not. 



—195— 

Let us now return to our analysis of bulletin 108, same 
page. "The fact that the child of tuberculous parents de- 
velops tuberculosis is by no means conclusive evidence that 
it has inherited the disease in the sense that it may have 
inherited physical conformation or mental characteristics." 
The writer confesses he does not clearly understand what 
the author of the above means. That his own view on this 
most important topic be clearly understood, the writer again 
quotes from ' 'Tuberculosis or Consumption:" "Children of 
consumptives \ though the environment be changed at birth 
die of this disease among other healthy children born of 
other far ents" 

Example: Mr. B. marries Miss T. Result of union, 
one child. Mr. B.'s family history is unique. Of the en- 
tire family, nine in number, consisting of grandparents, 
children and grandchildren, all die of tuberculosis, except 
one child of three, of diphtheria. Miss T. is of good family 
history, but is delicate. Knowing th£ above history, the 
child is taken and reared among other healthy children, yet 
dies of tuberculosis, aged twelve; the writer being the last 
attending physician. It seems to the author that in this 
case an entity was transmitted. Who can determine ? 

Another question bearing on the above now comes to 
view. Is physical conformation or mental characteristic 
transmitted ? Common observation shows that it certainly 
is. This child looks like her father. That child acts like 
his mother, etc. A likeness, similarity or entity is here 
seen. 

To be more explicit, is the entity of facial expression, 
etc., as seen in heredity, one and the same as the entity of a 
prepared soil by suspension ? It is not. In the former case 
it seems to be the result of a natural law or unfolding, 
whereas in the latter it is the result of a law violation or 
suspension. Each is an entity, and each comes under the 
head of heredity, but neither, so far as known, is controlled 
by a germ. This may appear strange, but "truth is strang- 
er than fiction." 

And now for a bit of experience. "The experience at 



— i go — 

this station with tuberculosis in swine, given on another 
page, gives a forcible illustration of the manner in which 
the disease may even skip a generation, to reappear in full 
force in the next and yet not come under the law of heredity 
as above defined." 

Benjamin Franklin was pre-eminently a practical man. 
He said to England, in 1776, that the proper way to eat a, 
large cake is to commence at the edge. The above is a 
large cake, and we propose to take Franklin's advice. Our 
nibbling is only at the edge. If the law of tuberculosis be 
true — and we think it is, ideally, at least — we can skip not 
only one generation, but five or six generations in succes- 
sion — ad libitum — and reinstate the disease in any genera- 
tion in less than eight weeks. This may also seem strange, 
but this in mathematics is called a corollary. 

"Again, there is a possibility of prenatal infection from 
either parent, previously referred to, which would be quite 
a different matter from constitutional heredity." This is 
the same old story of the germ theorist. Infection without 
a soil. How could there be "prenatal infection?" Can a 
plant grow without a soil ? If there be growth there must 
be soil — ask any biologist. If there be prenatal soil, this is 
heredity — the condition of growth. 

We now give the algebra of the germ theorist. We 
wish to be strictly fair. 

a - Health. 

b - The tubercle bacilli. 

c - Tuberculosis. 

The formula reads as follows: 
a ~ b = c. 

I^et us examine. Mr. B., what is your age? Twenty- 
five. Are you in perfect health ? Never better; just took 
out a policy for twenty thousand dollars; examined by three 
physicians and all say first-class risk. Please step this way 
one moment, Mr. B., I want to examine your sputum. A 
microscopical examination is made. Tubercle bacilli are 
found. Mr. B., did you eat butter for breakfast ? Yes, sir. 
Please examine the butter. Tubercle bacilli are found. 



—197— 
Mr. B., where have you been this morning? Walking in 
the open air. Please examine the air. Tubercle bacilli are 
found. Let us examine the formula: 

a + b '- c, 
i. e. y health -J- tubercle bacilli = tuberculosis. (Mathemat- 
ics don't lie.) This man has got tuberculosis. Bring in 
tuberculin and let us make a test. If there be a reaction he 
has got the disease without doubt. Tuberculin confirms. 

Ladies and gentlemen of the medical profession, this is 
medical science as taught today. Millions of our fellow- 
beings are hastening to eternity. Is it not time to call a 
halt? 

Let us proceed. "It is true that either of these forms 
of transmission of the disease given would be in one sense 
a hereditary transmission, but it would be transmission of 
infective material, not of actual disease nor of diathesis. 
The difference may at first sight appear to be hair-splitting, 
but, in fact, this difference is of fundamental importance," 
etc. 

The above is rather a singular statement. Please ob- 
serve—it is hereditary transmission, yet it is not hereditary 
transmission. It seems like hair splitting, yet it is of fun- 
damental importance. To the writer it appears like — it 
either rains or it don't rain, for it is very evident if it don't 
rain it must rain. 

We now open a field for controversy. "Because there 
can be no hope of overcoming this dread scourge until the 
fatalistic idea that it is a constitutional disease can be dis- 
placed by a clear conception of its contagious character." 
The writer thinks if we wait until "the fatalistic idea that 
it is a constitutional disease can be displaced' ' we will wait 
until Mother Earth lays by for re-pairs and receives a new 
axle-tree. In our judgment the constitutional will remain. 
But we leave this for the future to determine and talk of 
other things at this time. 

If the view herein be clearly unde rstood or correctly 
interpreted, it is seen an attempt is made to show a law in 
tuberculosis — an inviolable law; that heredity is a factor 



— 19» — 

aiding this law in an extension of the disease; that all dis- 
ease of this nature of whatever character is governed by 
this law. 

THE LAW OF SUSPENSION, 

The first stage in each case of tuberculosis is one of 
suspension. This creates a condition of tissue which allows 
the growth of tubercle bacilli. The tubercle bacilli do not 
cause the disease, but in many cases render it more fatal — 
fatal in that they cannot be removed — as a rule, they con- 
tinue to grow; fatal in that their growth consumes the air 
which should be taken up by the system; fatal in that their 
growth renders the lung tissue incapable of perfect aera- 
tion, etc. 

If in the stage of suspension before a growth takes 
place or while there is yet a feeble growth, perfect aeration 
be established or re-established — according to this law — the 
disease disappears and health is restored. In other words, 
if a perfect being — meaning by this one free from heredity 
as a factor — maintain a perfect aeration there can be no 
tuberculosis. Tuberculosis is, therefore, a disease of ill- 
ventilation or imperfect aeration. What, then, is the alge- 
braic formula for tuberculosis in the various stages of the 
disease ? 

a - Health. 

b = Suspension. 

c - Heredity. 

d - The tubercle bacilli. 

e - Tuberculosis. 

e' - more fatal. 

e" - most fatal. 

a -f b - e (formula i) 
i. e., health with suspension added means tuberculosis. 
Or transpose b: 

a - e — b (formula 2) 
i. <?., health is suspension taken away from tuberculosis. 

a -fb jc-e' (formula 3) 
i. e., health with suspension and heredity is tuberculosis of 
a more fatal type. 



—199- 

a -p b -p c 4- d - e" (formula 4) 
i. e. } health with suspension, heredity and the tubercle ba- 
cilli added means tuberculosis of the most fatal character. 
This, the writer thinks, is the mathematics of tubercu- 
losis. Other formulas can be given — 

a -j- b -p c - e' (formula 3). 
Transpose b -~ c. 

a - e' — b — c, but a - e — b (formula 2). 
Things equal to the same thing are equal to each other. 
Therefore — 

e — b = e' — b — c cancelling e = e' — c (formula 5). 
i. e., tuberculosis is rendered less fatal by the removal of 
heredity. 



— 200 — 



THE NECESSITY OF A ITORE PERFECT 
AERATION. 



We are told in Genesis the Lord formed man of the 
dust of the ground, breathed into his nostrils the breath of 
life and he became a living soul. Whatever the belief as to 
the genetic account of creation , this much is certain : In the 
race of life man excels. The swallow of today is the swal- 
low of the first century. The lion and tiger eat the same 
food and procure it in the same way. Not so with man. 
He alone of all animate creation has shown wisdom and 
skill in environment. 

We rightly feel proud of this, yet there is reason for 
humility. 

To him who reflects and compares man's estate with 
the domestic mammal, it is evident: 

ist. The number of still-born to man is vastly in ex- 
cess to the mammalia. 

2d. The number of deformed or abnormal births to 
man is vastly in excess to the mammalia. 

3d. Of normal births toman, the number who die nat- 
ural deaths before maturity is vastly in excess to the 
mammalia. 

If, then, the writer observes correctly, man presents the 
majority of still-born, deformed and of premature deaths. 
Should the comparison be made with the wild mammal the 
divergence is more marked. 

The conclusion follows: Man with a living soul, or in 
the exercise of reason, shows physical deterioration. 

Per contra, the animal without soul or reason has 
physically held its own. If true, these statements are 
worthy our careful consideration. Let us try to consider 
comprehensively and wisely. 

The word child nood is used as the period from concep- 



tion to maturity. This, as will be seen, is the word in its 
most comprehensive sense. 

At conception the factors that enter the life of the em- 
bryo are largely the health and vigor of the parents. The 
purity of blood, strength of organism, predisposition, etc., 
all must enter. 

During gestation the blood of the mother is the blood 
of the fetus. The life and health of the fetus is the life and 
health of the mother. This follows of necessity. From 
birth to maturity the life and growth of t!ie child is mainly 
of his own volition, assuming there be proper food and care. 
If at conception the blood of one or both parents be 
impure, if during gestation the blood of the mother be im- 
pure, if after birth the environment or food of the child be 
improper so as to render its blood continuously impure — we 
have the condition of impure blood from conception to ma- 
turity or for the entire period of childhood. Nor is the 
condition shown an anomalous one among the civilized. 

Multitudes of such cases are seen in every generation. 
Being so common and so easily recognized the only wonder 
is that its true value is not duly weighed. 

For illustration: Should impure food be given the 
mother during gestation, or to the child during infancy, it 
is readily seen the health is soon impaired. It is impaired 
through impure blood. We have spoken of this elsewhere. 
But improper food is not the only means of blood impair- 
ment. There are many other ways. One of the most prev- 
alent is non-oxygenation. In other words, improper venti- 
lation of the blood as it flows in the life current leads to its 
impurity. It leads to its impurity in two ways. 

i st. The venous blood needs oxygen to change to 
arterial. 

Venous blood must not circtilate in the arteries. 
Venous blood is impure blood and oxygen alone restores its 
purity. 

2d. The chyle poured into the venous current needs 
oxygen to complete its elaboration or formation into blood. 
Chyle must not circtilate in the arteries. Chyle is imper- 



— 202 — 

feet blood and oxygen alone completes its perfection. 

In defective aeration we have these two faults: An 
arterial blood containing venous blood from the veins and 
chyle from the lacteals. What is the result? The subject 
whose life depends on such blood becomes physically weak. 
The age of the subject makes no difference as to the fact of 
impurity — only as to power of resistance. 

The fetus in utero, the infant in arms, the child in the 
home are all subject to like influence. A fetus in utero 
may absolutely be killed by impurity of the mother's blood. 
Likewise an infant in arms or a child in the home in so far 
as they have the same powers of resistance. These facts are 
worthy of notice and must be taken into account in the con- 
sideration of the dread disease tuberculosis of which we 
speak later on. 

We said one who receives such blood becomes physi- 
cally weak. In what way? He is improperly nourished 
and a foreign element in his blood must of necessity act as 
an irritant. Let me illustrate. Suppose a healthy individ- 
ual eats food that is indigestible and that does not contain a 
requisite amount of nourishment. He may pariake of the 
food as often as he please but his system constantly grows 
weaker. '-Aall any one ask how he may become strong ? 
So in imperfect oxygenation. The blood contains an irri- 
tant and does not contain a requisite nourishment. The 
subject constantly grows weaker. He may become strong 
by a change of aeration. In the adult this change should 
take place. The adult has reason for a guide. Not so with 
the child. The fetus in utero, the infant in arms has no 
such monitor. He is subject to the whim or caprice, as it 
may be, of another. During the infant's minority his life 
and well-being are but as clay in the hands of a potter — 
moulded at his will. Should this potter be an ignorant 
crank the child must everlastingly suffer. 

Such is the condition or history of thousands in our 
land. These waifs who come into existence without thought 
or care on the part of the parents, become the future men and 
women to populate and repopulate the country. Is there 



— 203— 

wonder at degeneration ? Could it be otherwise ? In this 
connection the question may be asked, does not nature make 
an effort to reclaim her own ? True, nature makes an effort 
to secure more oxygen by a hurried respiration in the child, 
and in a measure and in some instances secures it. Many 
times it is like the one who tries to gain strength by eating 
food more often. 

If the nourishment be not in the food the rapid eating 
does no good. So in aeration. Rapidity of breathing ouly 
makes the irritant more apparent. It does not increase the 
amount of nourishment. While this is true in regard to the 
child, it does not apply to the fetus. The fetus has no res- 
piration of its own. The oxygen of the fetus is from the 
mother's blood. If the blood of the mother contain but 
little oxygen, the fetus can secure but little and vice versa. 

The mother, then, during gestation, has it in her power 
to give or withhold oxygen. Does she in every case clearly 
understand this ? If so, does she so act ? 

Thus it is seen that the child or fetus is hedged in, in a 
peculiar way in regard to an essential of existence. The 
mother wrongs her offspring through ignorance. The off- 
spring must suffer the wrong through an inability to rectify. 
Since civilization began it has been so, and so it must re- 
main until by a clear recognition of facts we change the 
conditions. Should a child be denied food the public at 
once cries out. The wrong must be righted. Should an 
imbecile be born in the home the state provides for its care. 
Should a child become wayward reformatories are at hand. 
Should a child be still-born — from want of oxygen — no man 
in the land has courage to raise his voice. "God moves in 
a mysterious way, His wonders to perform. He plants His 
footsteps in the sea and rides upon the storm." Thus the 
major part of the deaths in childhood are providentially ex- 
plained. How consoling to the bereaved, "The Lord has 
given, the Lord has taken away, blessed be the name of the 
Lord." This, it seems to the writer, is a perversion of 
Scripture in the present instance. But there are other per- 
versions. 



— 204 — 

W£ stated that during gestation the mother has power 
to give or withhold oxygen from the fetus. In health this 
is true. In disease, more particularly of the lungs, this 
statement should be modified. A woman who has diseased 
lungs marries. The disease is so extensive it is difficult for 
her to properly aerate her blood. The field for aeration is 
so small. She becomes pregnant. A double work must 
now be done. Not only must she aerate the blood for her- 
self, but also for the fetus. If the field were formerly 
small, how is it now ? Either the mother or the child, or 
more commonly, both must suffer. 

It seems to the writer that one who maintains heredity 
is not a factor in the transmission of disease, does not clearly 
understand the situation. 

Heredity is a factor not only in the transmission of sim- 
ilarities, but also in disease itself wherever aeration of the 
blood is concerned. It must be true. So that whatever 
the view as to the intermarriage of consumptives — weak 
lungs beget weak lungs and weak lungs beget an infant 
with imperfect aeration of the blood — the primary step in 
the advancement of tuberculosis. Without this primary 
step the disease is unknown. 

In corroboration of what has already been stated we 
herewith present the following typical cases: 

Case i. Mrs. G. , aet. about 37 — in good health — has 
had two confinements. On both occasions her children 
were weak and purple in color on delivery. For several 
weeks prior to confinement she staid closely in the home and 
took but little exercise. Her husband is several years her 
senior and is in poor health. At the third pregnancy — her 
last, I was notified of the above facts and ordered light 
exercise during the last weeks and small doses of chlorate of 
potassium three times a day. Child was more vigorous 
and less purple. 

The ages of the children range about two years apart 
and the following is the present history twenty years later: 

The eldest is delicate, but is able to act as a clerk in a 
dry goods store. The second died at nine or ten years of 



—205— 

age of asthenia. The third is now about twenty — the pic- 
ture of health — and graduates the coming season. 

The writer thinks a supply of oxygen during intra- 
uterine life has done thus much for him. 

Case 2. Mrs. S., set. about 30, in delicate health and 
has weak lungs. Has had three confinements. The child- 
ren's ages range as follows: Between the eldest and second, 
four years. Between the second and third, two years. 

During gestation of second child the mother's health 
is unusually poor; indigestion, cough and abscesses on var- 
ious parts of the body. At confinement instrumental deliv- 
ery is used owing to the size of the child — ten and one-half 
pounds. The father's health is good. Soon after the birth 
of this child it is observed the breathing is rapid and at 
times irregular. The child is fretful and nervous and sel- 
dom gives the mother a full night's rest. Every tooth a 
pang, every cold a burden. Treatment is instituted early, 
but is of little avail. Continued on these lines for upwards 
of tw r o years. Dr. W. , Sr. , of R , one of the best phy- 
sicians of Northern Ohio, is called in consultation and after 
a careful examination, said, "It is my firm belief this child 
car not be reared." 

What is the treatment henceforth? A walk or run 
around the house once or twice each morning after being 
dressed. Result: The child begins to improve and contin- 
ues to do so until he wants to be out of doors the entire 
time. Fourteen years have elapsed. 

What is the present status at nearly sixteen years of 
age ? Last year this boy w r as captain of a foot ball team 
that w T on in nearly every encounter and this year he throws 
the sixteen pound iron ball in a forthcoming athletic contest. 
Other cases could be given. In the face of these truths who 
can deny the value of a more perfect aeration ? 

Dr. F. N. Otis, in his classical work on "Genito-Uri- 
nary Diseases," '83, says in substance as follows: In gonor- 
rhoea, if the purulent discharge come in contact with a 
healthy mucous membrane it causes the disease. He 
further adds,, this is not true of syphilis. In this disease 



— 2o6— 

there must be contact and also an abraded mucous surface. 
The writer has long held and \et maintains that a healthy 
or abraded mucous surface and the contact of the living 
tubercle bacillus does not constitute tuberculosis. There 
must be something more, viz.: The precedent state. With- 
out this state there can be no transference of the disease or 
contagion. With this state the disease is readily transferred 
in the conditions named. 

Herein is a radical difference of belief which must be 
settled before a clear light can be diffused. Let us endeavor 
to make this still more plain. Dr. Russell says— we quote 
his writings for they have been scattered over the land by 
the Health Beards in various parts of the country — Dr. Rus- 
sell says: "The tubercle bacillus, not being inherited, but 
passing into the body from the outside, how does it get 
there ? Under what conditions does it pass from the outside 
to the inside of the body ? Under what conditions does it 
live and propogate there ? It is impossible to demarcate the 
answers to these questions as clearly as the questions them- 
selves."— (Dr. Jas. B. Russell, B. A., M. D., LL. D., Sen- 
ior Medical Officer of Health, Glasgow. Republished by 
permission by the State Board of Health of Massachusetts, 
1896.) 

The writer answers these questions briefly. The tub- 
ercle bacillus gets there by simply growing in a soil prepared. 
It passes and grows under the conditions of suspension of 
atmospheric influence. It lives and propogates under the 
same conditions of suspension. In other words, if there be 
imperfect aeration of the blood from any cause and for 
ary length of ti?ne, all the conditions named will be found. 
On the accuracy of this statement the writer pledges his 
ideal reputation and challenges controversy. What greater 
assurance can be asked ? We read in current medical liter- 
ature that of the births in Massachusetts fifty per cent die 
before they are fifteen years of age. The deaths are largely 
due to tuberculosis. How sad a commentary on present 
civilization ! The burden of rearing children is prior to fif- 
teen. This burden falls largely and heavily on the elder part 



— 207 — 

of every community, the part that practically needs sup- 
port. Think of it ! A child who has grown to near matur- 
ity and is educated to a point of self-support is ruthlessly- 
taken away. Can this condition be averted ? 

After twenty years of close study and accurate research 
the writer answers this question in the affirmative. 

Give us the method at once. By legal restraint in mar- 
riage, by careful watching of the mother during gestation, 
by physical culture in the child, by accurate ventilation in 
the home and elsewhere, in a word, by a perfect aeration 
thousands of these youths may be annually rescued to years 
of usefulness. Is it worth the labor? The writer thinks 
it is. 

In conclusion, with due deference to education, do not 
tie yourself too closely to the germ theory of tuberculosis, 
for rest assured in the near future it will be shown that 
germs have little value. 

Tuberculosis is a constitutional disease, induced by im- 
perfect aeration, is based on law and can be controlled. 

The mathematics of the situation is as follows: The 
death rate from tuberculosis is in direct ratio to abeyance of 
atmospheric influence. 



-208 — 



THEORY OF THE PRODUCTION OF 
TUBERCULOSIS. 



DES DEUT5CHEN VATERLAND. 

1 'Was ist des Deutschen Vaterland ? 
Ist's Preuszenland, ist's Schwabenland ? 
Ist's wo am Rhein die Rebe blukt? 
Ist's wo am Belt die Move zieht ? 

O nein ! Nein ! Nein I 
Sein Vaterland musz groszer sein. 

* * * 

"Das ist des Deutschen Vaterland 
Wo Eide schwort der Druck der Hand, 
Wo Treue hell vom Auge blitzt, 
Und Liebe warm in Herzen sitzt, 

Das soil es sein ! 
Das, wackrer Deutscher, nenne dein I 

"Das Ganze Deucsthland soil es sein 1 
O Gott ! von Himmel sich darein !■ 
Und Gieb uns rechten deutschen Muth, 
Das wir es licben treu and gut I 

Das soil es sein I 
Das Ganze Deutschland soil es sein," 

We have elsewhere stated, and again affirm, tuberculo- 
sis is a constitutional disease dependent largely on the evils- 
of civilization and governed by the following law: The 
death rate from tuberculosis is in direct ratio to abeyance of 
atmospheric inflnence. Suspension of atmospheric influ- 
ence is, then, the primary cause of tuberculosis,, not the 
germ tubercle bacillus, as commonly believed. 

In a former article we attempted to show that deep 
breathing, in so far as it removes suspension, removes the 
primary cause in the same ratio, and is thereby curative. 
We now try to set forth more clearly the true cause or na- 
ture of this most serious disease, and in so doing to give as- 
best we may our theory of its production. 






— 209 — 

In the first place, please bear in mind that tuberculosis 
is a constitutional disease. Medical writers of this genera- 
tion are somewhat at variance on this important topic. Some 
classify the disease as constitutional and then define as local 
and infectious; this seems contradictory. Others believe it 
a specific infectious disease, yet fail to state the condition 
under which the infective germ or cause enters. This 
essential is omitted — an unwarrantable fault. Still others 
recognize a condition or state of the system as necessary for 
its natural transfer; but boldly assert this condition or state 
cannot be named. The fallacy of this position is shown in 
"Tubercular Annotations." 

Nor is the diversity of belief confined to this alone. It 
is just as great on the question of heredity in tuberculosis. 
Ask the eminent German medical scientist of today if scrof- 
ulosis and tuberculosis be one and the same, and he will an- 
swer yes. In the same breath he will affirm heredity is a 
factor in scrofulosis, but not a factor in tuberculosis. Such 
teaching is illogical, and, we think, immoral. The emi- 
nence of the teacher ofttimes blinds the intellect. Let us 
endeavor to use logic and truth at the same time. If scrof- 
ulosis and tuberculosis be identical they are identical in 
transmission. The writer claims tuberculosis a constitu- 
tional disease — constiturionBl from the moment of inception; 
that scrofulosis and tuberculosis are not only alike in nature 
and manner of inception, but also alike in transmission. 

The time has come for medical men to assert with posi- 
tive earnestness that which they know. The air is full of 
skepticism and unbelief: The medical world is running 
wild after the sheerest fads. 

Do I speak the exact truth in saying the scientist is 
largely to blame? It is time, high time, to utter truths and 
stand by them in argument. What the world wants more 
than all else is men, high-minded men, who, knowing what 
is right, dare assert and maintain the same. The medical 
policy for the last few decades has been one of vacillation 
and inaptitude. In no line of work is this more clearly seen 
than in the management of tuberculosis ! The land of science, 



— 2IO — 

germs and serums shows its ravages most clearly. When 
will we control ? 

These and kindred topics could be presented indefinite- 
ly. Why prolong the discussion? It is not that we wish 
to demolish the structure that has been reared with so much 
painstaking, but rather to notify the residents of danger. 
The foundation is unstable. The building will ultimately 
be removed and rebuilt with greater care. At present we 
are reprehensible if we do not notify. 

It was an ancient belief that the life of the animal is in 
the blood. There is much in this statement to meet accept- 
ance and commendation. As the blood deteriorates the 
health declines; as' the blood flows out the life departs. 
There is a health standard, so that, as a rule, show the char- 
acter or composition of the blood and the stamina or vitality 
of the individual is seen. 

Much may be said in extenuation of this belief. Yet 
on reflection it is seen many things must enter in the com: 
position of the blood; or, perhaps better, many factors are 
essential in the production or formation of the blood in its 
perfection. We enumerate some of the more important. 
As a rule, the richness of the blood depends on the quality 
of the food. The quantity of food determines more the 
amount of blood. Yet there are exceptions. A rich food 
may secure a large blood supply or a plain food a rich sup- 
ply. There is something strange in this provision of nature. 
Each animal seems to adapt itself to the food ingested. We 
see well-nourished people who live on plain food and illy- 
nourished people who live on rich food. The richness or 
plainness of the food does not always alone determine the 
quality of the blood. Other factors enter in its production. 

One of these is digestion. It is not alone the quality or 
amount of food ingested, but the amount digested, that goes 
to restore an impoverished blood. At all ages a constant 
waste is going on in the system. In youth there must be 
also a supply for growth. This waste and supply must be 
met. It is met by ingestion and digestion of food. But 
digested food is not blood. Before it becomes blood it must 



■211 — 



be taken up and poured into the proper channel, conveyed 
to the lungs and aerated. It is then blood, and can be used 
or utilized by the system in its growth or development. 
This seems very simple, but the latter, or aeration, has ap- 
parently been ignored by many of the profession. 

Today there are leading lights in practice who prefer 
to call in a microscopic germ to account for a faulty aera- 
tion. To the writer this seems absolutely silly. Germs do 
not naturally grow in hea-thy tissue. Imperfect aeration 
prepares the soil for the so-called germ of tuberculosis. 
Change the aeration in this early stage and there is no tub- 
erculosis, or, if you prefer — germ growth. This is certainly 
worth knowing. 

But is not the idea of germ growth recent medical 
science ? Is not the germ theory adopted by all scholars of 
eminence ? Can we set aside so great an array of evidence ? 
What would be the ultim ate outcome should we discard the 
germ theory of tuberculosis ? Would we not again go back 
to our forefathers and start anew? In reply to this we ask, 
what would the world miss today should all knowledge of 
tubercle bacilli be cast into everlasting disuse ? The writer 
speaks candidly and upon reflection when he asserts the 
germicidal or serum treatment of tuberculosis is no better 
than former treatment. If modern treatment is of no avail, 
why should we cling to it with so death-like a pertinacity ? 
Echo answers, why? It should ever be the aim of the 
scholar to learn to unlearn what has been learned amiss. 
We have been learning amiss. Let us correct the error and 
mend our way. 

Two theories, in particular, have been held in the past 
as explaining the presence of tuberculosis. Let us consider 
these for a moment: 

i. Altered condition of blood originating in a perver- 
sion of nutrition, or tubercle, an exudation. 

2. Increased cell development and multiplication of the 
included nuclei, or tubercle, a new growth. 

The second or cell growth was held by the world-re- 
nowned Virchow, but repeated investigations by careful 



— 212 — 

histologists have failed to find said growth. The support- 
ers of this theory have therefore been few. 

The perverted nutrition as found in the first theory is 
said to be owing to many causes, viz., vitiated air, imperfect 
assimilation, hereditary taint, etc. 

Please notice that vitiated air, imperfect assimilation, 
hereditary taint, etc., bring in a large field of disease. It 
seems to the writer that when so many causes are assigned 
as producing one and the same thing, viz., tuberculosis, we 
should carefully scrutinize, for such occurrences are rare. 
It is something as with the vender of medicine who has a 
remedy for the nomenclature of disease. One is apt to be 
suspicious of its intrinsic worth. 

The writer believes faulty or imperfect aeration pro- 
duces an altered condition of the blood. It is altered, first, 
in that the venous blood is not properly charged to arterial; 
second, in that the chyle is not properly transformed into 
blood corpuscles. This blood flowing to every part of the 
system causes or induces the constitutional disease known 
as tuberculosis. For mark, as already stated, tuberculosis 
is never a local disease. 

(a) Vitiated air may produce this same condition of 
blood or system. 

(b) Heredity may allow this faulty aeration or condi- 
tion of the blood. 

(c) Imperfect assimilation, etc., etc., we think have 
nothing to do with the condition named. 

We also take the liberty at this time to state that what- 
ever destroys or hastily eliminates the red corpuscles re- 
maining in the system hastens the progress of the disease, as 
child bearing, excessive venery, etc. The reason is ob- 
vious. Perfect blood is being formed slowly. The hasty 
destruction of red corpuscles from any cause leaves the sys- 
tem in a state of famine, which is slowly overcome. It is in 
this state the tubercle bacilli naturally enter the system and 
grow. I ask any fair-minded and candid man, do they cause 
the disease ? Is not the soil prepared before the vegetation 
takes root ? If so, should we control the soil do we not 



—213— 

control the disease ? Herein lies the secret of the control 
of tuberculosis. Herein lies the secret of the ameliorated 
condition of mankind during the last decade. Our life has 
afforded a better aeration of the blood. Afford a still bet- 
ter aeration and the disease tuberculosis is more fully con- 
trolled. Can we control perfectly ? Knowledge in this in- 
stance is power. Power gained in an avenue of life means 
greater insight in future trials. I«et us take courage and 
press steadily on. 

The question may be asked, what change takes place, 
in perfect aeration ? It is known in the change of venous 
blood to arterial, the dark red becomes a bright red. Gray, 
the anatomist, tells us this change is due to the oxygena- 
tion of the iron in the blood. Spectrum analysis shows 
this. In regard to the change that takes place in the chyle 
in the formation of red corpuscles we have little definite 
information. It is thought at present the white corpuscles 
are formed in the lymph ducts or glands, while the red are 
formed direct from the chyle. Certain it is, chyle is not 
blood; certain it is the fluid is still chyle when it enters the 
venous circulation. Passing directly to the lungs, it leaves 
them as blood. The change or conformation takes place 
during aeration. In the absence of further light we assume 
aeration changes chy le to blood. It is when an imperfect 
blood is formed, or, in other words, it is when there is an 
imperfect aeration, that the bacilli take root and grow. The 
imperfect aeration in every instance precedes the vegetable 
growth, or the soil precedes the growing plant. The veg- 
etable growth, then, may modify the disease, but is not the 
caasr- of it. 

The construction of the thoracic duct in being single, 
while many organs are placed in pairs: the plan of discharge, 
in that it commonly empties its contents into the left vein 
and not into the right, or both, are among the anatomical 
peculiarities of this alone. The commingling of the chyle 
with blood already devitalized and with the bulk of the 
body's lymph; the passing of the united stream to the lungs 
to combine with the oxygen of the air. shows a wisdom of 



- 214 — 

construction seldom seen. The exact change that takes 
place is not known, but the combined stream continually 
flowing gives life and vitality to the whole organism. We 
feel assured that when any change occurs in this current 
either by man's device or folly, the entire system must suf- 
fer. 7/ is no local disease. In point of fact, this is what 
is seen in surgery. Remove a tuberculous mass from any 
part of the body — does the wound heal readily ? Is the dis- 
ability removed entire? In no case is this true — plain evi- 
dence to the writer that tuberculosis is not a local disease. 
Treat the subject constitutionally; give him, in so far as 
possible, a perfect aeration of the blood, and I pledge you 
the patient in every case will receive a benefit. 

It is these little things which tell us plainly the law of 
tuberculosis must be true. 



—215- 



INTROSPECTION. 



By introspection or the introspective method is meant 
the studying of mental phenomena by means of one's own 
consciousness. Everything about us or within is a subject 
of consciousness. We are conscious of one's presence or 
absence, of an opinion or belief, etc. We study or grasp in 
its entirety as we lay hold of the mental phenomena con- 
nected therewith. So that the introspective method pre- 
supposes a rational being in its exercise. Mird is neces- 
sary to reason. 

The introspective method is used at this time not so 
much to look into or examine the individual as to search 
out or investigate theory. Medicine is full of theory — 
theory as to cause, prevention and cure of disease. Some 
are true, many are false. The wise physician discriminates. 
He distinguishes the true from the false. How better to do 
this than by the exercise of reason in the introspective 
method ? 

Today we have a theory of the disease tuberculosis. 
On what is it based ? Evidently, not on reason or analogy. 
It is based exclusively on microscopical examination. Cer- 
tain microscopic organisms are found in certain locations at 
certain stages of the disease tuberculosis. These are 
assumed to be the direct cause. The writer thinks this 
wrong. He has his reasons for so believing. Microscopic 
organisms do not naturally grow in health or induce disease. 

(a) Microscopic organisms, like all plant life, grow 
where the soil is properly prepared. 

(b) The preparation of the soil, in every case, precedes 
the growing plant. 

(c) The soil is, then, the first stage or cause of tuber- 
culosis. 

How is a soil prepared ? By suspension of atmospheric 



— 2l6 — 

influence. What does suspension of atmospheric influence 
induce ? A faulty aeration or impure blood. What are 
common methods of suspension ? 

(a) Heredity, in that an imperfect lung tissue aerates 
the blood in an imperfect manner. 

(b) 111 ventilation, in that an impure or impoverished 
atmosphere fails to furnish the requisite amount of oxygen. 

(c) Occupation, in that there is a mechanical obstruc- 
tion to aeration. 

In these and other ways a soil is prepared in the indi- 
vidual which allows the entrance of the growing bacillus, or 
so-called cause of tuberculosis. This growth, if cause at all, 
as already shown, must be a secondary one. 

Based on the same assumption is a theory of the pre- 
vention of tuberculosis. If the tubercle bacillus be the pri- 
mary cause of tuberculosis, and all germ theorists believe 
this, the prevention of the disease in theory is very simple. 
It is simply to prevent the entrance of the growing germ. 

In -practice prevention is found a very different matter. 
In truth, the germ naturally enters the system and grows 
without the rational aid of man. To prevent its entrance 
and growth, or in other words, to prevent tuberculosis where 
there is a favorable soil, according to present notions, is not 
in the power of man. Prevention of tuberculosis is, then 
■practically a dead letter. 

Look around you and see if this be not true. The eyes 
of the profession are slowly opening. Give us more light \ 

Based on this assumption, that tuberculosis is a specific 
infectious disease, is a theory of treatment. In the writer's 
judgment, in no phase of medical literature is common sense 
and intellect more perfectly held in abeyance. 

(a) Tuberculosis is caused by the tubercle bacillus. 

(b) The bacillus, in growing in the healthy system, 
gives out or throws off ptomaines, leucomaines, etc., which 
poison and ultimately destroy. 

(c) The extract of these same bacilli, grown under 
other circumstances, injected into the diseased system pre- 
vents their normal action or is cura-tive, Wondrous thought ! 



—2i7 — 

Suppose 3 r ou give a healthy man an ordinary dose of strych- 
nine. Suppose your neighbor practitioner injects another 
ordinary dose. Is there a sane man in the universe who will 
argue the one dose counteracts the other ? The germ theorist 
has been teaching this the last two decades. Ladies and 
gentlemen of the medical profession, are we professional 
thinkers or are we incorrigible asses ? 

On the same line of assumption is the theory of immun- 
ity. To claim in one breath that a plant growth throws out a 
poison which causes a disease and in the next to claim the 
same poison injected secures an immunity ! Rationally con- 
sidered, how could one and the same poison both cause and 
prevent a disease ? What shameless folly ! But, in this 
case, we leave out reason entirely, and ask: Does it do it? 

We stated suspension of atmospheric influence causes 
an imperfect aeration or impure blood. That this condition 
is found in all cases of tuberculosis we candidly affirm. 
That others now recognize this truth is plainly shown. Prof. 
Osier says: "The arrest or cure of tuberculosis is a question 
of nutrition entirely, and that the essential factor is to im- 
prove the resisting forces of the body so that the disease 
cannot make further progress or is eradicated. Fresh air 
and good food are the most important means by which 
the nutrition may be increased. (Maryland Medical Jour- 
nal.) Please remember these are the words of a renowned 
germ theorist. Please note Prof. Osier claims tuberculosis 
a specific infectious disease, yet treats it a s a constitutional 
one. The writer claims tuber culosis a constitutional disease, 
based on law, and treats it as such. Which is the more 
consistent ? We leave this to others. 

But mark, there is something of more practical worth 
to the living than the treatment of tuberculosis. Need I say 
prevention ? So soon as we clearly understand the cause of 
disease so soon are we able to see clearly a method to pre- 
vent the same disease. So long as we teach one thing and 
practice another so long the great mass of the world's peo- 
ple will remain in blissful ignorance. 

By a proper use of the introspective method we may not 
only examine our own theories, but those of others, and the 
world is thereby made wiser. 



— 218— 



INCIPIENT TUBERCULOSIS. 



"The forces of the universe are in league against a lie." 
— Emerson. 

Definition : A constitutional disease dependent largely 
on the evils of civilization, and governed by the following 
law: The death rate from tuberculosis is in direct ratio to 
suspension of atmospheric influence. 

Speculation has been rife whether tuberculosis is trans- 
mitted. Some have said yes, others no, and a vast host of 
the profession are as yet undecided. 

That the author's statement appear not biased, con- 
temporaneous writers are quoted: 

"Consumption is caused by a germ known as the tub- 
ercle bacillus, etc. This germ is not inherited, but is always 
contracted from some other case," etc. (State Board of 
Health of New Hampshire.) 

This statement, coming from so high a source, has the 
merit of being definite. There is only one fault we at pres- 
ent observe, viz., the forces of the universe are in league 
against it. 

"It is an admitted fact that no child is born with tub- 
erculosis, yet they do inherit that peculiar lymphatic, anaemic, 
poorly-nourished constitution which gives them but little or 
no resistance when exposed, "etc. (Jas.A. Burroughs, M.D.) 

"In 1 86 1 I attended a phthisical woman in her first 
confinement. She belonged to a consumptive family, had 
suffered herself before she got married, and died in the third 
week after confinement. The fetus was born at the end of 
the seventh month of utero-gestation, and lived a few min- 
utes only. There were numerous gray miliary tubercles in 
the tissue of the liver near the surface, a few in its perito- 
neal covering and the spleen, and on the pulmonary pleura." 
(A. Jacobi.) 



I 



—219 — 

Please observe, the one says "No child is born with 
tuberculosis;" the other says "I have seen tuberculosis in a 
a seven month's fetus." Does the fetus invariably die be- 
fore viability? If not, of what value is the "admitted 
fact?" 

The truth is, many children are born "with that pecul- 
iar, lymphatic, anaemic, poorly-nourished constitution," but 
only a proportion of them have tuberculosis. Why not all? 
To the writer the reason seems plain. The proportion who 
take the disease, in some way, have suspension of atmos- 
pheric influence; the others do not have said suspension. 

"The prevention of tuberculosis by prohibition of mar- 
riage of consumptives will remain an Utopia until human 
nature changes and the reason exerts a greater influence in 
such matters than the emotions." (St. Louis Medical Re- 
view.) 

If we clearly apprehend, there is a brighter future for 
humanity when reason has full sway. In other words, mar- 
riage can be regulated to diminish tuberculosis. This, if 
true, should be clearly understood by all. The minister, 
justice and judge alike need enlightenment. 

"Tuberculosis unquestionably may be inherited, but in 
what way and how often are unsettled problems." (Osier's 
Practice.) 

The writer, in his weak way, attempts to render mat- 
ters more clear and simple. In order to do so the germ the- 
orist is taken on his own ground. It is said tuberculosis is 
due to a germ, or rather tuberculosis is germ growth in the 
system. The writer thinks differently. He believes tuber- 
culosis is an induced state or condition under control, and 
germ growth simply secondary. His reasons for so believ- 
ing are as follows: No plant life can take root and grow 
without a suitable soil. The tubercle bacillus is plant life. 
Therefore the tubercle bacillus, in growing, has a suitable 
soil. If found growing in one's system a suitable soil is 
found in said system; otherwise it does not grow. No 
growing tubercle bacilli are found in a healthy organism. 

It is seen the soil must -precede the -plant grozvth. To 



— 220 — 

this rule or law there is no exception. Herein lies the fal- 
lacy of the germ theorist: He assumes the plant tubercle 
bacillus causes the disease tuberculosis because it is usually 
found in every typical case. 

As in creation primeval the sun came into existence 
before vegetation, so in tuberculosis suspension of atmos- 
pheric influence ever precedes the advent of the germ. 
Flood the earth with sunlight and vegetation at once starts. 
Suspend atmospheric influence in the individual and the 
same condition prevails — the germ grows. Withdraw all 
sunlight and vegetation ceases to exist. Sunlight to the 
earth's vegetation is as pure atmosphere to earth's people. 
Perfect ventilation means freedom from tuberculosis. 
The knowledge and application of this simple truth will rid 
us of the most deadly disease known to the human race. Is 
not such knowledge worthy attention ? The writer so con- 
siders it. Let us proceed. 

Much time and labor have been spent in determining 
how the tubercle bacillus enters the circulation and grows in 
various parts of the body, how the germ enters the mother's 
blood-current ard by means of the fetal circulation is con- 
veyed to the fetus. By some this is thought to be truly 
marvelous. When the view entertained by the writer is 
closely examined he thinks the inexplicable is rendered more 
plain. The condition precedes the growth in every instance. 
It has been shown this must invariably be the esse. A 
child or person has the condition or precedent state. It 
matters not for illustration how obtained — by heredity or 
suspension in the individual. He has the condition or soil. 
All that is requisite is the presence of the germ. These so- 
called germs are everywhere present. Is there anything 
mysterious in their growth ? Yes, but the mystery is as 
the growth of a blade of grass or kernel of wheat. ' 'Simply 
this and nothing more." 

At times much ado is made because certain meats con- 
tain tubercle bacilli. Has it ever entered the mind of the 
scientist that meats may be tuberculous in the absence of 
tubercle bacilli ? The writer has the temerity to assert that 



—221 — 

sometimes, though infrequent, this may be the case. Sup- 
pose these germs are thus found in said meat ? Is there 
any general outcry when these same germs are found in the 
food we eat and the water we drink? If not, why not ? 
.Is not the major portion of our food and drink taken cold — or 
not sterilized — before eating? Are not our meats sterilized 
in the cooking? "Consistency, thou art a jewel." 

Again, we are told so much about a "former case," as 
if no case of tuberculosis occurred unless there be a preced- 
ing case in the same house or neighborhood. This seems 
absolutely silly. If tubercle bacilli cause the disease tuber- 
culosis; if tubercle bacilli be everywhere present, w T hat is 
the use to everlastingly harp on the "former case ?" 

If the germ truly causes the disease, and germs contin- 
ually float in the atmosphere, rationally considered one germ 
would cause the disease the same as the germs in a "former 
case." Hence, we have illustrated cases like the following: 

Mrs. K. is sixty years of age and has an infant grand- 
son living at her house. Mrs. K. has had a chronic cough 
for years. The grandson is losing flesh and having night 
sweats. He at times has a slight cough. After several 
weeks he dies. No autopsy. Physicians assert this little 
fellow had tuberculosis, and that he caught the disease from 
his grandmother. Are you satisfied with the inception of 
the disease? The writer claims a soil is first prepared. 
When prepared, the tubercle bacilli, from whatever source, 
readily grow. 

For a writer to assert that every extension of the dis- 
ease is due to a "former case" would be to assert that germs 
must be fresh in order to infect new victims, i. e. } the infec- 
tious material is carried with the fresh germ, or, in other 
words, is external to itself. No true germ theorist could 
accept this. We are therefore led to believe it is the germ 
alone that grows, but it grows in a soil already -pre-pared* 
The germ does not prepare the soil. 

The fundamental principle involved is not how recent 
the germ, not from whence derived, but how is the soil pre- 
pared in which the germ thrives. Do we hold in our hands 



— 222 — 

the preparation of the soil ? Can we prevent its forni3tion? 
If answered in the affirmative, we can control tuberculosis. 

Take, for instance, the case presented by Dr. Jacobi. 
The mother is tuberculous, t. e. y has suspension of atmos- 
pheric influence. The soil is prepared and tubercle bacilli 
are growing in her system. Like produces like. The fetus 
in utero has the soil of the mother. If bacilli grow in the 
mother they likewise grow in the child. They are thus 
growing when observed by Dr. Jacobi. 

Another mother is healthy. The fetus in utero is also 
healthy. While tubercle bacilli may be found in the tissue 
or blood of both mother and fetus, they are not found grow- 
ing in said systems. Why not ? There is no soil, no sus- 
pension of atmospheric influence. Hence, freedom from 
tuberculosis. 

Another case presents. The father is in the last stage 
of tuberculosis — so feeble he is unable to walk but a few 
steps. His wife is in fairly good health and becomes preg- 
nant at this time. A miscarriage shows tubercular devel- 
opment in said fetus. How explained ? It will at once be 
admitted this is an unusual method of transmission. Tub- 
erculosis usually descends from parent to child through the 
mother. Not always so. The fa'Jiermay also transmit the 
disease. All conditions must be favorable for this consum- 
mation. What are the conditions? The germ theorist ex- 
claims it is readily explained: "The seed of disease is in the 
semen of the father." The writer asks: "My dear sir, or 
madam, how can a seed grow without a soil?" True, the 
tubercle bacillus may be in the semen. It may also be in 
the blood of the mother or fetus. 

Why does the so-called germ grow in the fetus ? Let 
us attempt an answer. The mother, apparently, is in good 
nealth. She takes little or no exercise. What of this ? 
Her very inactivity causes suspension of atmospheric influ- 
ence in herself and fetus, and allows the tubercle bacilli to 
grow. Hence, growth and consequent miscarriage. The 
same condition prevails if suspension occur in any other way. 

This, we think, a correct interpretation of facts. 

After twenty-five years of active practice the writer 
recalls abortion and miscarriage enough times to recognize 
the certainty of heredity in tuberculosis. Knowing this, 
he thinks he has a clear idea of the inception of the disease. 



■223— 



AS OTHERS SEE US. 



<c O wad some power the giftie gie us 
To see ourse?s as others see us ! 
It wad frae monie a blunder free us 
And foolish notion." — Burns, 

Colorado Springs, Col., August 27, 1898. 
Dr. H. H. Spiers, Ravenna, O. 

Dear Doctor — Allow me to congratulate you on your 
article in the Medical Record, "The Control of Tuberculo- 
sis." I was much interested in the article and am in strong 
sympathy with you on many points mentioned in it. 

I cannot, however, entirely agree with you as to the 
fact that if a person is kept clean, takes daily exercise, in- 
hales pure air, that such a person cannot develop tuberculo- 
sis if heredity is thrown out, as I have seen cases that ful- 
filled all these requirements to a most perfect degree and yet 
did develop tuberculosis, possibly through milk as a child, 
the germ lying dormant for years. 

I send you a reprint of some of my work. 
Yours truly, 

C. F. Gardiner. 

The above is one of many letters in our possession. It 
is difficult for us to answer or take note of all. 

In the first place, we ask no one to entirely agree with 
us. In truth, we do not expect this. The fact that one 
differs in some minor point is prima facte evidence he has 
ideas of his own. When one accepts ideas, style, language, 
etc., of another, and swallows it, however crude, it is 
marked evidence that person lacks individuality. We try 
to be broad ourselves and allow the same latitude to others. 
At the same time a law must not be set aside to attend 
minor details. The law should have precedence, 

We fear our able contemporary does not clearly com- 
prehend the nature of tuberculosis. We are led to believe 
this from the "reprint of work" sent us. The author seems 
to be grappling with the germ theory of this disease. L,eave 



the germ theory alone. Set it aside for the present and 
carefully examine the law of tuberculosis. What is tuber- 
culosis ? A constitutional disease dependent largely on the 
evils of civilization, and governed by the following law; 
The death rate from tuberculosis is in direct ratio to sus- 
pension of atmospheric influence. 

Two things are noticeable: (a) Tuberculosis is a con- 
stitutional disease; (b) tuberculosis is governed by law. 

In each of our articles we have endeavored to make 
these facts clear. The one quoted in the Medical Record is, 
we think, no exception. 

So that if our friend, Dr. Gardiner, fails to take in 
these truths he fails to properly appreciate our effort, though 
he congratulate. For this we feel sorry. 

The error of Dr. Gardiner is not uncommon. This 
mistake is seen on every hand. 

Why are we so dull of apprehension ? This is certainly 
un-American. Americans have perceptives and use them. 
Why so dull in this ? Two reasons can be readily assigned: 
(i) Education; (2) authority. 

In one sense it is true: we believe what we are taught 
to believe. Europeans have saddled upon us a germ theory 
of tuberculosis. This theory is taught in the schools. We 
are educated in this belief. Germs there must be, for we 
can see them. Seeing is believing. Cause the disease they 
must, for they are found with the ailment. No further 
questions need be asked. If one ask why these germs are 
found in certain conditions he is regarded an heretic. If 
one suggest there may be the condition in the absence of 
germs he is regarded as a lunatic. If one speak of the con- 
dition prior to the entrance of growing germs he is asked if 
he studied bacteriology in Heidelberg. Bacteriology and 
high-power microscopes are at a premium. Reason and 
common sense are excluded. 

Does the writer express a truth ? If so, is not this 
j udgment manifestly unfair ? Education — school learning — 
is one thing, and education — progression — another. The 
one is memorizing dry statistics; the other the use of the 



—225 — 

intellect in the higher sense. Which shall it be ? 

Again, there is reverence of authority. A young fresh- 
man, on being asked what he thought of the professors in 
the school he was attending, replied: "They are foine men, 
but they have no hids." Now herein is a fault with many 
authorities: They have no "hids." A professor in medi- 
cine who sits down and deliberately compiles statistics week 
after week, then quotes them in his lectures as law and the 
gospel has no "hid." He may be pre-eminent in science; 
he is only eminent in common sense. 

Can we improvise "hids" for them so situated? This 
is a question not only for the near future, but for all time. 

We travel in ruts. If one step from the beaten track 
he is regarded an heretic or lunatic. Yet mark, it is these 
side-steps that make progress in science, literature and the 
arts. 

To return: "If a person is kept clean, takes daily ex- 
ercise, inhales pure air, that such a person cannot develop 
tuberculosis if heredity is thrown out." If heredity be 
thrown out we take it for granted the subject is perfectly 
healthy so far as tuberculosis is concerned. The sentence 
then reads: If a healthy person be kept clean, takes daily 
exercise and breathes pure air he cannot develop tubercu- 
losis. 

Keep clearly before you the proposition. What is it to 
develop tuberculosis? "Answer ye who will." Tubercu- 
losis has been denned a constitutional disease, etc. If one 
develop tuberculosis he must develop or acquire a constitu- 
tional disease. How does one develop or acquire a consti- 
tutional disease? This one disease, tuberculosis, is devel- 
oped or acquired in one way — only one — suspension of at- 
mospheric influence. If there be no suspension of atmos- 
pheric influence there can be no tuberculosis. If the healthy 
person be kept clean, takes daily exercise, etc., there is no 
suspension. Therefore there can be no tuberculosis in his 
case. 

"But," says Dr. G., "I have seen cases that fulfilled 
all these requirements to a most perfect degree and yet did 



— 226 — 

develop tuberculosis," etc. The writer asks, "How can 
these things be?" Various explanations may be given. 
The one most probable is that Dr. G. is mistaken in his 
cases. 

In this connection perhaps another conversation will be 
allowed. Some time ago, on meeting my frier d Dr. X. C. 
Scott, of Cleveland, O., he congratulated me on a paper read 
at a certain society. His language was somewhat as fol- 
lows: "Doctor, it is seldom I listen to papers outside my 
specialty, but yours was an exception — one of the best I 
ever heard. But, by the way, your theory of suspension 
don't work. Why, this very summer I traveled all through 
Mexico, and I saw many cases of tuberculosis. The climate 
is warm, the people live in the open air, and if you are right 
there ought not to be any disease of this kind. You are 
evidently mistaken." He continued: "Oh, by the way, 
doctor, do you know of a peculiar custom of sleeping in 
Mexico ? They always wrap their head and face in a 
blanket. 

Is it clear why there is tuberculosis in Mexico ? 

Suppose some one should tell you that Dr. Gordon, of 
Mexico, committed suicide by drowning. How can it be 
possible ? There is but little water in Mexico. How much 
water does it take to drown when one is so disposed ? So 
suspension of atmospheric influence ma) be produced by 
simply covering the month during sleep. 

It requires but little suspension to produce a diseased 
constitution. A diseased constitution so caused allows the 
tubercle bacilli to enter and grow — so-called tuberculosis. 

With due credit to Dr. Gardiner for his honesty, wis- 
dom and acuteness of perception, is it not probable he is 
mistaken? Have any of these patients — referred to as 
healthy — had stenosis of the air passages ? If so, suspen- 
sion of atmospheric influence. Have they had measles or 
pertussis ? If so, was recovery perfect ? If not, suspension 
of atmospheric influence. Did any of these healthy patients 
ever work at an unhealthy vocation, as stone-cutting, etc.? 
If so, suspension of atmospheric influence. Did any of these 



— 227 — 

parties, at any time, have a history of slow recovery from 
typhoid fever, with lung symptoms ? If so, suspension of 
atmospheric influence. Tuberculosis frequently follows 
after the lapse of years. 

One other question : Who in any land can say in any 
case that heredity is excluded? Heredity, like the sun's 
influence, is felt in every land where a race exists. I^et no 
one assert the contrary — I knovfthis is true. Hereditary 
influence no man can measure. When one asserts heredity 
is left out he only 'approximately determines this truth — 
nothing more. Dear doctor, the writer feels assured you 
are mistaken. 

We close with an extract from a letter referring to 
State regulation of marriage. 

Fall River, Mass., August 24, 1898. 
H. H. Spiers, M. D., Ravenna, O. 

My Dear Doctor — I have just read your article in the 
Medical Record of August 20th, and wish to thank you for it. 
As to the question of State regulation of marriage I think 
you might have gone a step further than you did. The bill 
introduced into the Ohio Legislature was certainly a step in 
the right direction, and, as you say, in the years to come 
some measure of similar character will be enacted for the 
protection of the body politic. 

I am at present at work along the same lines and may 
have something to send you one of these days. State regu- 
lation of marriage is as important and as much a function 
of the State as regulations covering vaccination, contagious 
diseases, boards of health and the like. 
Very truly yours, 

Geo. L. Richards. 



— 228 — 



INDEX. 



PAGE 
Artificial Immunity 62 

Abeyance of Atmospheric Influence 103 

Annotations ,..111 

An American Need 181 

As Others See Us 223 

Bicycle a Preventive 68 

Cause of Tuberculosis 53 

Control *. . 79 

Catechism 123 

Duties of the Hour 117 

Deep Breathing vs Tuberculosis 175 

Dawning 185 

Education 42 

Food Product , 46 

Germ Theory 58 

Heredity , 26 

Introspection 215 

Incipient Tuberculosis 218 

Law in Tuberculosis 15 

Legislation 70 

Medical Theories 11 

Marriage 19 

Medicine 1 70 

Mathematics in Medicine , 190 

Necessity of a More Perfect Aeration 200 

Outlook 158 

Preliminary Statement 9 

Precedent State 32 

Status of the Bacillus 88 

Theory of the Production of Tuberculosis 208 

Vagaries 165 

Whom to Marry 38 



FEB 9 1903 



